FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to operative urology. A method for percutaneous cystolithotripsy for large bladder calculi, which includes, at the first stage of surgical treatment for patients with cystolithiasis, an ultrasound-guided cystostomy and the installation of a 3-way Foley catheter Ch 20. 3-5 days before the proposed lithotripsy and 3-5 days after it, a complex drug therapy, which includes daily instillation of the combined Coletex-ADL gel in a volume of 20 ml into the bladder, as well as sodium hyaluronate 40 mg in a volume of 50 ml with an exposure of 30 minutes. 3 hours before the operation and 24 hours after the operation, a solution of fosfomycin 3 g is administered orally. After the drug therapy, cystolithotripsy is performed. The Amplatz-shell CH 30 is successively installed along the insurance conductor, then, under the control of the nephroscope, a laparoscopic bag is inserted into the bladder cavity, then the stone is placed in the laparoscopic bag and pneumatic cystolithotripsy is performed, then a basket is passed through the working channel of the nephroscope, with which the stone is captured and crushed stone inside the basket according to the method described above, followed by washing the stone fragments from the bag.
EFFECT: method allows to increase the efficiency of treatment of patients with cystolithiasis with large bladder stones, reduce the risk of damage to the bladder wall during cystolithotripsy, the occurrence of hematuria, postoperative inflammatory process in the bladder, there is no risk of urethral injury, allows the operation to be performed in patients with aggravated anamnesis.
1 cl, 2 ex, 5 dwg
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Authors
Dates
2022-07-29—Published
2021-12-30—Filed