The “sling” procedure easily relieves urinary incontinence
According to the definition of the International Continence Association, urinary incontinence is an involuntary leakage of urine, a health problem that can be objectively described and can attract social attention. In a survey of nearly 4,000 people, Director Wei Zhongqing found that the prevalence of adult female incontinence in Nanjing was 29.8%, with stress incontinence being the most common, accounting for 63.4%, which is the type of incontinence that occurs when you hold your breath or laugh a little. In addition, the prevalence of stress incontinence, mixed incontinence and other urinary incontinence increases significantly with age.
Director Wei’s survey also found that advanced age, high number of births, and low education are also some of the risk factors of concern. As China enters an aging society, the number of patients with female urinary incontinence has increased significantly. However, the actual consultation rate for the disease is low due to a lack of awareness of seeking treatment, shyness or the belief that it is irrelevant.
Currently, there are more than 100 surgical methods for stress urinary incontinence, but many of them are not as effective as they could be. In recent years, foreign scholars have introduced a new procedure of mid-urethral “sling” (TVT, TVTO), which uses a synthetic sling material with high strength and toughness and very good histocompatibility, and the procedure requires only a small incision in the anterior vaginal wall and pubic bone, which is simple, safe, and highly effective (success rate of The procedure is simple, safe and highly effective (success rate of 94% or more). It has become the first choice for female urinary incontinence surgery. Since mastering this emerging technology in 2000, Director Wei Zhongqing has been the first to carry out and succeed in the province, and has performed TVT and TVTO for more than 600 female patients so far, which has completely solved their urinary incontinence that has plagued them for many years and improved their quality of life.
Among the patients treated by Director Wei Zhongqing was a 48-year-old Ms. Zheng, who often experienced involuntary urine flow when coughing, sneezing, laughing or exercising, etc. For seven years, she suffered from urinary incontinence, and her physical and mental health and social interactions were seriously impaired. After careful examination, she adopted the new “TVT” procedure, in which a small incision is made in the anterior vaginal wall and abdomen of Ms. Zheng, and a “sling” is inserted to lift the middle part of the urethra. The operation was quick and easy, minimally invasive and safe, and took only 40 minutes to complete. She was discharged from the hospital on the third day after the surgery. After a follow-up visit one year later, Ms. Zheng told the doctor that she was no longer incontinent no matter how much she ran, laughed or did heavy physical work.
Sacral nerve modulation therapy cures urinary dysfunction
Chronic urinary dysfunction is very common in clinical practice, mainly including urge incontinence, urinary frequency and urgency, chronic urinary retention and chronic pelvic pain syndrome. since the 1990s, the concept of neuromodulation of urinary reflex has been paid more and more attention, and functional electrical nerve stimulation has been applied to treat chronic urinary dysfunction. Sacral nerve stimulation and sacral neuromodulation, which have emerged in recent years and continue to be used in clinical practice, offer a new way of treating patients with voiding dysfunction.
There was an 18-year-old boy named Zhichao from Hefei, Anhui Province. When he was born, Zhichao was very cute with a tiger’s head and a tiger’s brain, but his parents noticed that their son’s urine line was very thin, and it was getting thinner as he grew older. The parents had a thunderbolt from a clear sky with severe hydronephrosis in both kidneys and ureters and reduced kidney function. The anxious parents took little Zhichao on a long road to seek medical help. In order to prevent further aggravation of the hydronephrosis, little Zhichao, who was just over 4 years old, had to have a cystostomy in the lower abdomen to relieve the pressure on the upper urethra. The cystostomy was done in the lower abdomen to relieve pressure on the upper urethra. Although the surgery brought a ray of hope to his young life, the fistula made it impossible for him to enjoy the pleasures of nature as much as other little boys, and he was very tired and exhausted. Yet even so, the disease struck again four years ago. This time it was more serious, because the water accumulation in the kidneys worsened leading to serious damage to kidney function, the toxins in the body could not be expelled, and upper gastrointestinal bleeding began to occur, so they had no choice but to have a fistula in the abdomen again.
Director Wei told them that this is one of the most advanced methods in the international treatment of urinary disorders: a very thin electrode is placed in the third sacral foramen of the sacral spine, and the reflexes of the nerves are regulated by the weak electrical impulses issued, so that they can urinate like normal people. Moreover, this surgery is less invasive, with fewer side effects, good results and safe. Zhi Chao’s parents made up their mind and let Zhi Chao undergo sacral nerve modulation therapy. The operation went very smoothly, and after 7 days of testing, the residual urine volume dropped linearly from 200ml to 50ml, which was beyond the imagination of Cui Zhichao and his parents. The cystostomy tube was removed, a luxury he had been afraid to achieve for a long time.
A new combined transvaginal and bladder procedure was used to stop the vesicovaginal fistula
”The clinical manifestation is constant vaginal urination, and the fistula can be located in the bladder triangle or at the bottom of the bladder.
The first thing you need to do is to get a good idea of what you are getting into. The first thing that I noticed was that my urine was always flowing involuntarily throughout the day, so I thought it was strange that I wasn’t a child, but I couldn’t control my urine on my own. If you say that you are incontinent due to pelvic floor relaxation, you are not yet 40 years old. What is going on? After observation, Ms. Li found that her urine did not flow through the urethra, but from the vagina, due to shyness, Ms. Li did not go to the hospital in time, always hoping that it would heal naturally. The woman’s vagina has been soaked in urine for a long time, and she smells like urine, and has a serious dermatitis on her inner thighs. The family heard about Director Wei Zhongqing’s expertise in the treatment of this disease and finally found him for treatment.
Based on Ms. Li’s symptoms, and after detailed questioning of her past medical history, Dr. Wei determined that a “vesicovaginal fistula” was the culprit causing the urine to flow out of the vagina. A cystoscopy confirmed Dr. Wei’s judgment that there was a fistula at the base of Ms. Li’s bladder that was connected to the vagina and needed to be repaired through surgery. In view of the large vaginal fistula, Professor Wei decided to use a new combined transvaginal and bladder procedure to repair the vesico-vaginal fistula, which took less than an hour. She was discharged from the hospital in just three days.
Afterwards, according to Director Wei Zhongqing, this combined repair is much more difficult and complicated than the simple transvaginal repair and transabdominal repair, and requires a high level of operator, but the operation has good results and high recovery quality. Director Wei also reminded women that the main symptom of vesico-vaginal fistula is urine leakage, and the skin of the vulva, inner thighs and buttocks is chronically impregnated with urine, which can lead to varying degrees of dermatitis, rash and eczema, and if scratched, can cause secondary infections. To add to the headache, this condition can cause serious psychological disorders. The actual fact is that you will be able to get rid of the problem by using the actual web site.
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The actual “faucet rust”
If you are over 50 and have an increased number of nighttime urination, frequent urination, urgency, weak urine flow, and wet underwear, you may have developed benign prostatic hyperplasia. This is actually a common disease among middle-aged and elderly men, so there is no need to be overly alarmed, but because it affects the physical activity and social ability of the patient, causing both physical and mental pressure on the patient, it cannot be ignored. Patients must properly assess their condition before receiving treatment, and then the doctor will choose the most appropriate treatment method.
Among the patients treated by Director Wei Zhongqing, there is a case that is typical of Master Zhang: Master Zhang has been urinating less smoothly for the past few years, dripping and always taking several times to get clean. The old man recently encountered another annoying thing, the poor urination of his own at night will be like a child bedwetting, his partner thought that people inevitably will not be older this condition, help Zhang moncler clean up, change the sheets, and did not care too much. The next night, the old man wet the bed again, the family panicked, worrying that the old man had urinary incontinence, rushed to the hospital to treat the old man. The first thing you need to do is to take a look at the old man’s past medical history and find out that he has difficulty urinating due to prostate enlargement, which causes chronic urinary retention and when the pressure in the bladder rises to a certain level, it exceeds the resistance of the urethra. The actual fact is that the actual person’s condition is significantly better than before the surgery, and the person’s urination is much smoother and no longer “bedwetting” at night.
The actual incontinence is not the same as the real incontinence, but it is a kind of “pseudo” incontinence, also known as “filling incontinence”, which is actually caused by the prostate enlargement. This is why Professor Wei especially reminds the middle-aged and elderly men, especially those with long-term urinary difficulties and “pseudo” urinary incontinence, to consult an experienced urologist and, if necessary, to identify the neurogenic bladder with the help of urodynamic tests, never to be taken lightly and to go to the hospital early for treatment.
Minimally invasive lumpectomy in vivo
Elimination of urinary stones
For patients with urinary stones, there is always a desire to remove stones from the body in the least invasive and most economical way to restore health. At present, lumpectomy and internal shock wave lithotripsy have become the advanced representatives of minimally invasive surgery, which can save 95% of patients from the damage of open surgery and remove stones easily with minimum pain.
Since the late 1980s, Dr. Wei has treated tens of thousands of patients with ESWL, which is the best choice for renal pelvic and ureteral stones within 2 cm, with an overall success rate of about 70-90%. The ureteroscopic lithotripsy technique is a good choice, especially for patients with renal colic, emergency ureteroscopic lithotripsy can achieve immediate results and quickly and effectively relieve the patient’s pain; while percutaneous nephrolithotomy (PCNL) is effective for the treatment of complex intra-pelvic multiple stones keratolite cystine stones, the patient under anesthesia in the lumbar percutaneous puncture into the kidney, after The nephroscope is placed in the lumbar percutaneous puncture into the kidney under anesthesia, and the nephroscope is inserted from the original fistula channel after 48 hours to break the stones again. Ureteroscopy instead of nephroscopy is less traumatic and has fewer complications, and if combined with holmium laser, it can solve stones that are difficult to break in the renal calyces.
The specific type of lithotripsy used depends on the equipment available at the hospital and the experience of the surgeon. The current ultrasound lithotripters are more effective in not only breaking up stones but also in suctioning them out, while the holmium laser is more efficient and more suitable for soft ureteroscopy. Over the years of clinical practice, we have witnessed the development of lithotripsy technology from “open stone extraction shock wave lithotripsy minimally invasive lithotripsy non-invasive lithotripsy”, modern minimally invasive surgery to achieve high efficiency, accurate, complete, easy to drain the purpose, generally the patient can get out of bed the next day after surgery, 3-4 days can be discharged. It is worth mentioning that after the successful treatment of stones, it is still important to prevent recurrence. Under the leadership of Director Wei Zhongqing, the Second Affiliated Hospital will carry out the analysis of stone composition, according to the composition of stones, adjust the diet structure, pay attention to the quality of drinking water to avoid the recurrence of stones.