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用于治疗尿道成形术失败后球部尿道狭窄的热膨胀性尿道镍钛合金支架Memokath

Thermoexpandable Urethral Nickel-Titanium Stent Memokath for Managing Urethral Bulbar Stricture After Failed Urethroplasty.

作者信息

Martov Alexey G, Plekhanova Olga Al, Ergakov Dmitry V, Baykov Nikolay A

机构信息

Department of Urology and Andrology, IPPE of A.I. Burnazyan SSC FMBC, FMBA of Russia, Moscow, Russia.

Department of Urology, D.D. Pletnev City Clinical Hospital, Moscow Health Department, Moscow, Russia.

出版信息

J Endourol Case Rep. 2020 Sep 17;6(3):147-149. doi: 10.1089/cren.2019.0146. eCollection 2020.

Abstract

Urethral stenting became popular two decades ago, but nowadays its frequency is slightly decreased because of the rising application of urethroplasty. Today urethral stenting is reserved only for failure after urethral reconstruction or in cases when the plastic surgery is unfavorable. The Memokath stent (Pnn Medical A/S, Kvistgaard, Denmark) is manufactured from a biocompatible alloy of nickel and titanium and known to be the most popular in this field. A 38-year-old man with a history of 9 years Memokath urethral stenting was admitted to our clinic with obstructive lower urinary tract symptoms. The indication for Memokath stenting was repeated recurrences after endoscopic and reconstructive operations. The plain radiography showed a normal position of the stent and only the endoscopic examination revealed its total calcification. New superpulse thulium fiber laser has been used to free the stent from the stones and safely remove it without additional urethral injury. The postoperative time was within normal limits, the catheter was removed on the fourth day after operation. Three months follow-up was without stricture recurrence. We continue active surveillance of the patient. The calcification of the stent could be properly diagnosed endoscopically; the Memokath stent could be safely removed in 9 years after implantation; thulium fiber laser is effective and safe in the management of encrusted urethral stent.

摘要

尿道支架植入术在二十年前开始流行,但如今由于尿道成形术应用的增加,其使用频率略有下降。如今,尿道支架植入术仅用于尿道重建失败后或整形手术不可行的情况。Memokath支架(丹麦Kvistgaard的Pnn Medical A/S公司生产)由镍钛生物相容性合金制成,是该领域最受欢迎的支架。一名有9年Memokath尿道支架植入史的38岁男性因下尿路梗阻症状入院。Memokath支架植入的指征是内镜手术和重建手术后反复复发。X线平片显示支架位置正常,只有内镜检查发现其完全钙化。新型超脉冲铥光纤激光已被用于将支架从结石中松解并安全取出,而不会造成额外的尿道损伤。术后恢复时间在正常范围内,术后第四天拔除导尿管。三个月的随访未发现狭窄复发。我们继续对该患者进行积极监测。支架钙化可通过内镜正确诊断;Memokath支架在植入9年后可安全取出;铥光纤激光在处理结壳尿道支架方面有效且安全。

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Stricture recurrence after urethroplasty: a systematic review.尿道成形术后狭窄复发:一项系统评价
J Urol. 2009 Oct;182(4):1266-70. doi: 10.1016/j.juro.2009.06.027. Epub 2009 Aug 14.

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