The Twin Amplatz Sheath Method: A Modified Technique of Percutaneous Cystolithotripsy for Large Bladder Stones in Female Patients
نویسندگان
چکیده
To minimize the operative time and to avoid open cystolithotomy in women with large bladder stone (>5 cm), we present here a modification of percutaneous cystolithotomy, a well-described standard procedure for urinary bladder stones. With this technique, suprapubic percutaneous access was achieved under cystoscopic guidance. The suprapubic tract was dilated and an Amplatz sheath of 30 Fr was placed. Simultaneously, the urethra was sequentially dilated with fascial dilators and a 28 Fr Amplatz sheath was guided into the bladder and the foot end of the table lowered to 20° to facilitate high-speed outflow of irrigant and stone particles. A 26.5 Fr nephroscope was passed through the suprapubic Amplatz sheath and the stone was fragmented by intracorporeal pneumatic device keeping the stone close to the proximal end of the urethral Amplatz. These maneuvers help in washing out stone fragments periurethrally and keeping the endoscopic vision clear while breaking the stone.
منابع مشابه
Effect of Amplatz Sheath on Cystolithotripsy for Women with Large Bladder Stone
OBJECTIVE This study compared the effect of endourological procedures with or without the Amplatz sheath (AS) on cystolithotripsy. METHODS We retrospectively analysed 18 patients who underwent treatment for bladder stone over 30 mm. This study consisted of two groups, namely, patients who underwent cystolithotripsy with an AS (AS group) and those who underwent standard procedure without an AS...
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Bladder stones account for ~5% of all urinary tract stones and are associated with bladder outlet obstruction, neurogenic or augmented bladders, infection or foreign bodies. Small bladder stones can be managed efficiently by transurethral methods and larger stones by open or laparoscopic approaches. However, the optimal management of multiple intermediate sized stones is controversial. Options ...
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