Clinical Value Of Combined Laparoscopic And Cystoscopy Operation In The Treatment Of Bladder Diseases

Objective: To explore the application value of laparoscopic combined cystoscopy endoscopy in bladder diseases(bladder non urinary tract epithelial benign tumor,bladder diverticulum,vesical vaginal fistula,urachal lesion,ectopic bladder ectopic and so on),and analyze its feasibility and safety.Method: Clinical data of 11 patients with bladder diseases treated by laparoscopic combined cystoscopy endoscopy from Jan.2012 to Dec.2017 in the Department of Urology in Fujian Provincial Hospital were retrospectively analyzed,including 4 cases of bladder non urinary tract epithelial benign tumor(3 cases of paraganglioma of the bladder and 1 cases of cystectomy),2 cases of bladder diverticulum,2 cases of vesical vaginal fistula,2 cases of urachal lesions(1 cases of urachal fibrous hyperplasia in 1cases of urachal cyst),1 cases of ectopic IUD bladder.The operative time,bleeding volume,postoperative hospitalization time,indwelling catheter time and postoperative complications were recorded and followed up for 3-33 months.Result: All 11 patients were successfully operated,none of whom were transferred to open surgery.Non-epithelial Bladder benign tumor 4 cases :The average operative time was(213.75 ± 91.23)min;the average intraoperative bleeding volume was(38.75 ±41.70)ml;the average postoperative hospital time was(8.50±1.91)d;the average time of indwelling catheter was(8.75 ± 3.50)d;there was no complication after operation;no tumor recurrence was found in 4 patients during the follow-up period of 3-33 months.Bladder diverticulum 2 cases:the average operation time was(212.50 ±67.17)min;the average intraoperative bleeding volume was(20.00 ± 14.14)ml;the average postoperative hospital time was(18.00±4.24)d;the average indwelling catheter time(14.00 ± 0.00)d;one cases repoeted postoperative complications;the dysuria symptoms of the patients were significantly improved,with no effort to urinate,frequency of urination,urination urgency,and urinal pain,during a follow-up period of 8to 15 months.Vesical and vaginal fistula 2 cases: the average operation time was(265.00± 42.43)min;the average intraoperative bleeding volume was(30.00 ± 0.00)ml;the average postoperative hospital time was(23.50±4.95)d;the average indwelling catheter time was(14.00±0.00)d;there was no complication after operation;during a follow-up period of 5 to 9 months,one cases had no leakage urine,no urinary frequency,urgent urine and other complications,while another had no leakage of urine before the removal of the catheter,and a small amount of urine leakage after removal of the catheter,which is still in the outpatient follow-up.Urachal lesions 2 cases:the average operation time was(142.50 ± 10.61)min;the average intraoperative bleeding volume was(50.00 ±42.43)ml;the average postoperative hospital time was(5.50±0.71)d;the average time of indwelling catheter was(9.5 ± 3.54)d;there was no complication after operation;no tumor recurrence was found in 2 patients during the follow-up period of 21-28 months.IUD ectopic bladder 1 case: the operation time is 130min;the intraoperative blood loss is 3ml;the postoperative hospitalization time is 10d;the indwelling catheter time is 7d.Conclusion:Laparoscopic combined cystoscopy endoscopy is safe and effective in the treatment of bladder diseases such as bladder non urinary tract epithelial benign tumor,bladder diverticulum,vesical vagina fistula,urachus disease,ectopic bladder ectopic and so on.It can reduce the difficulty of laparoscopic surgery for bladder disease,help to locate bladder lesions accurately and guide bladder resection and suture closure.