This is an automatically translated article.
Bladder neck sclerosis is a condition in which the bladder neck sphincter is fibrotic due to congenital, chronic inflammation or prostate surgery, causing disordered urination. Laparoscopic bladder neck dissection for bladder neck sclerosis is a treatment applied to patients, helping to restore bladder function to normal.
Manifestations of bladder neck sclerosis are urinary retention, urinary incontinence, difficulty urinating, nocturia, urinary disorders. Cases with such manifestations will be indicated for endoscopic bladder neck dissection to treat bladder sclerosis.
1. Contraindications to laparoscopic surgery for bladder neck sclerosis
The following patients need contraindication to cystectomy cystectomy for bladder neck sclerosis:
There is urethral stricture associated with urinary tract infection, which has not been treated stably, There are general medical conditions. The body cannot be operated on: Cardiovascular disease, blood pressure, diabetes ... Long-term urinary disorders have greatly affected kidney function: kidney failure
2. Prepare for laparoscopic bladder neck dissection
Bệnh nhân cần tiêm kháng sinh dự phòng trước khi mổ
The treatment method for bladder neck sclerosis will be performed by a urologist. After a clinical and subclinical examination, the patient is eligible to perform laparoscopic surgery. is needed.
For the patient:
Be prepared for surgery like other urological laparoscopic patients from the night before: Clean genitals clean Shave pubic hair Enema Fleet for clean stools Fasting a little before surgery At least 6 hours of test and prophylactic antibiotic injection before surgery Besides, the medical equipment system needed for laparoscopic bladder neck dissection surgery to treat bladder neck sclerosis is properly prepared, fully enough to ensure safety when performing endoscopy for patients.
3. Steps to perform endoscopic treatment of bladder neck sclerosis
Spinal anesthesia Obstetrical position Disinfection of the surgical area, spreading the preparation of laparoscope, laparoscopic instruments Dilating to examine the urethra Place the device through the urethra into the bladder, install the lavage line in surgery Laparoscopy evaluate bladder status, 2 ureteral openings, whether there are bladder tumors or stones, evaluate the bladder neck area. Bladder neck narrowing Using a laparoscopic cutter to cut the bladder neck. Can slit the bladder neck at 6 o'clock to widen the bladder neck Take blood carefully, pump out the pieces and send them to pathology. Place a 3-pronged catheter for continuous bladder irrigation During laparoscopic surgery, the patient is always monitored for blood. pressure. After surgery, pay attention to monitor bladder lavage to urine bag to detect early bleeding, or urinary catheter blockage. The patient needs to keep the flow of water in and out of the bladder continuously continuously tearing blood clots in the bladder causing blockage of the catheter. At the same time, monitor the whole body for infection after surgery, use appropriate antibiotics at the right time if there is a fever.
4. Management of complications after laparoscopic surgery
hình ảnh mô tả mổ nội soi xẻ cổ bàng quang
After laparoscopic bladder neck dissection to treat bladder neck sclerosis, the patient may experience some complications as follows:
During surgery, there may be bladder perforation (rare), we should switch to open control surgery. The narrow fibrous bladder neck cannot be placed with the machine, it can be combined with hand-in-hand bladder opening to place the laparoscopic cutter Bleeding after surgery causing bladder blood clots, urinary catheter blockage, we can pump out blood clots and give wash continuously at a higher speed. To register for examination and treatment at Vinmec International General Hospital, please book an appointment on the website for service.
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