Kingo Pernille S, Ryhammer Allan M, Fuglsig Sven
Department of Urology, University Hospital of Aarhus , Skejby, Aarhus, Denmark .
J Endourol. 2014 Oct;28(10):1178-82. doi: 10.1089/end.2011.0512. Epub 2013 Apr 3.
Bladder calculi account for 5% of urinary tract calculi in the Western world, and many different treatment modalities have been presented throughout the decades. We report our clinical experience using the Swiss LithoClast® Master (SLM).
The SLM is a rigid, hand-held endourologic probe including a pneumatic lithotriptor and an ultrasonic lithotriptor. Attached to the ultrasonic modality is a suction system. The two lithotriptor modalities are controlled by a footswitch and can be activated separately or simultaneously. The SLM is used via a rigid endoscope. Indications for treatment were medical complaints such as hematuria, lower urinary tract symptoms, pain, recurrent urinary tract infections, recurrent bursts of balloon in indwelling catheters, and difficulties performing clean intermittent self-catheterization.
From August 1, 2009, to August 1, 2011, 27 patients were treated for bladder calculi (24 men). Five had a neurogenic voiding dysfunction, 3 had prostate cancer, and 19 had benign prostatic enlargement or detrusor muscle insufficiency. Median age was 74 years (range 45-86 years). Stone clearance was obtained in 26 (96%) patients. Stone burden was one or multiple bladder calculi. Median stone size of the largest stone in each patient was 20 (5-40) mm. Under the same anesthesia, two patients underwent a transurethral resection of the prostate because of a very large prostate. Median lithotripsy time was 60 (range 20-144) minutes. All patients were discharged within 24 hours.
The method described is a safe and quick method for endoscopic lithotripsy of bladder calculi rendering the patients stone free in the vast majority of cases. The procedure can be performed as day-case surgery.
在西方世界，膀胱结石占尿路结石的5%，数十年来出现了许多不同的治疗方式。我们报告使用瑞士碎石星® Master（SLM）的临床经验。
SLM是一种刚性手持腔内泌尿外科探头，包括气动碎石器和超声碎石器。超声模式连接有一个抽吸系统。两种碎石模式由脚踏开关控制，可单独或同时启动。SLM通过刚性内窥镜使用。治疗适应证为血尿、下尿路症状、疼痛、复发性尿路感染、留置导尿管反复球囊破裂以及清洁间歇性自我导尿困难等医学症状。
从2009年8月1日至2011年8月1日，27例膀胱结石患者接受了治疗（24例男性）。5例有神经源性排尿功能障碍，3例有前列腺癌，19例有良性前列腺增生或逼尿肌功能不全。中位年龄为74岁（范围45 - 86岁）。26例（96%）患者结石清除。结石负荷为单发或多发膀胱结石。每位患者最大结石的中位大小为20（5 - 40）mm。在相同麻醉下，2例因前列腺非常大而接受了经尿道前列腺切除术。中位碎石时间为60（范围20 - 144）分钟。所有患者均在24小时内出院。
所描述的方法是一种安全、快速的膀胱结石内镜碎石方法，在绝大多数情况下可使患者结石清除。该手术可作为日间手术进行。
