تدبير حصيات المثانة
Abstract
تم علاج 45 مريضا من بين 95 مريضا راجعوا بقصة حصيات مثانية أي بنسبة 47.3% في مشفى الأسد الجامعي في اللاذقية بين عامي (2004–2002). حيث تم:
1. دراسة الأسباب المؤدية إلى تشكل حصيات المثانة, وعلاقتها مع آفات الجهاز البولي السفلي والعلوي حيث شكلت ضخامة الموثة السبب الأول لحصيات المثانة وبنسبة 66.5% للمرضى المراجعين, وللمرضى 83.6% المعالجين.
2. تدبير حصيات المثانة بالشكل الأمثل تبعا للسبب الذي أدى إلى حدوثها بغية الوصول إلى أفضل النتائج مستخدمين وسائل تشخيصية متممة مثل (الإيكو – التنظير البولي السفلي -. .. ). حيث خضع 44% من المرضى للعلاج التنظيري, و41.6% للعلاج الجراحي, و4.4% لتفميم المثانة, و8.8% للإجراءات التنظيرية والجراحية بعد تفتيت الحصيات الكلوية المرافقة بالأمواج الصادمة من خارج الجسم.
3. دراسة علاقة حصيات المثانة مع التغيرات المرافقة في الغشاء المخاطي, ودورها في إحداث سرطان المثانة حيث لوحظ وجود تبدلات مزمنة لا نوعية لدى 4.2% من المرضى المراجعين مع مناطق مشبوهة بالتنظير البولي السفلي, ولم تعزل أية حالة لتنشؤ أو عسر تصنع الغشاء المخاطي.
4. دراسة المضاعفات الناجمة عن حصيات المثانة, حيث لا تقتصر على الحصيات بحد ذاتها ولكن قد تنجم عن الآفات المرافقة, حيث بلغ معدل المضاعفات 13.2% توزعت مناصفة بين العلاج التنظيري والجراحي
5. لوحظ أن الحرقة البولية والإلحاح البولي هما العرضان الأكثر شيوعا وبنسبة 90% من المرضى المعالجين
6. لوحظ سيطرة إصابة الذكور بنسبة 97.73% من المرضى المعالجين, وخاصة بالأعمار المتقدمة.
of 95 bladder stones patients, only 45 of them (i.e. 47,3%) were treated in AL-ASSAD University Hospital in LATTAKIA, between (2002-2004). the following was done:
1. studying the cases of bladder stones formation and the relation ship between them and lower and upper urinary tract lesions. Prostate inflammation was the first cause of bladder stones in 66.5% of attended patients, and 83.6% of treated patients.
2. treating bladder stones in the best way according to the cause of their formation in order to achieve the best results using diagnostic complementary, methods such as Echo, cystoscopy... 44% of treated patients underwent cystoscopy procedures, 41.6% had surgical treatment, 4.4% had cystostomy, 8.8% had cystoscopy and surgical procedures after (extra corporeal shock waves lithotripsy - ESWL -) application .
3. studying the relation ship between the bladder stones and other changes in the mucosal membrane and their role in the bladder cancer formation. There are chronic nonspecific changes in 4.2% of attended patients. There were no detection of malignancy or dysplastic changes in the mucosal membrane.
4. The complications resulting from the treatment of bladder stones itself or from the accompanied lesions were studied in details, the rate of complications was 13.2%, divided equally between endoscopic and surgical treatment.
5. The most common symptoms were urgency and burning of micturition in 90% of treated patients.
6. The rate of males was 97.73% of treated patients and they were mostly of old age.
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