在有或没有水凝方法的柔性尿路尿镜术中提取石头:一个随机的,多中心的安全性和可行性研究
T Amiel1, A Neisius2, C Netsch3
1Department of Urology, Technical University of Munich, School of Medicine and Health, Munich, Germany. Thomas.amiel@tum.de.
World journal of urology
|October 31, 2025
概括
水凝方法通过显著改善提取小碎片 (<1毫米),而不会增加风险,从而提高了在柔性尿路透镜术期间提取石的效果. 需要进一步的研究来证实长期有效性.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 腎石病的管理方法
背景情况:
- 标准的柔性尿道透镜 (fURS) 往往无法去除所有的小结石碎片,增加了复发风险.
- 开发了mediNiK®水凝方法,在fURS过程中嵌入和提取微小碎片.
- 在结石手术中,改善无结石率至关重要.
研究的目的:
- 评估水凝方法的安全性和可行性,用于在fURS过程中提取石块碎片.
- 为了确定水凝方法是否改善了小于1毫米的碎片的检索.
主要方法:
- 预期的,随机的,多中心试验,涉及患有结石>8毫米的患者.
- 患者随机分配为使用水凝 (组1) 或单独使用fURS (组2) 的fURS.
- 评估了激光后的碎片检索,按大小分类,并监测了不良事件.
主要成果:
- 与第二组相比,水凝组 (第一组) 检索的碎片<1毫米 (1716比209) 和>1毫米 (310比118) 的碎片显著更多.
- 每位患者的分析显示,在第一组中删除的<1毫米碎片更多 (中位数为7对0,p<0.003).
- 第1组的手术持续时间更长 (80分 vs. 62分,p=0.02),没有报告严重不良事件.
结论:
- 水凝方法是fURS的安全和可行的补充,用于增强石块检索.
- 使用水凝方法证明了小碎片 (<1毫米) 的提取效果得到改善.
- 需要进行更大规模的研究来评估长期无结石率和由于样本规模较小而导致的复发.
相关概念视频
Urinary Tract Calculi VI: Surgical Management
361
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
361
Urologic Endoscopic Procedure: Cystoscopic Examination
2.2K
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
2.2K
Imaging Studies II: Ultrasonography
344
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
344
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
1.0K
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
1.0K
Urinary Tract Calculi III: Medical Management
189
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
189
Imaging Studies I: Kidney, Ureter, and Bladder Studies
260
Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
260


