Our experience of laser lithotripsy under local anesthesia in the treatment of bladder stones in obese male patients

Abstract

Introduction: Our century has witnessed a significant increase in obesity, which in its turn, bears several major risks in management of systemic anesthesia. In this context, use of this treatment without general or regional anesthesia is of critical importance for patients under this group. Aim: In present study, it was aimed to analyze the efficacy and safety of holmium laser lithotripsy (HLL) under local anesthesia in obese male patients with bladder stones. Material and Method: In our study, we evaluated a total of 64 obese male patients with body mass index (BMI) ≥30 kg/m2, diagnosed with bladder stones and treated HLL under local anesthesia. Demographic data, stone size, operative time, urethral catheterization time and length of hospital stay of the patients were analyzed. Visual Analogue Scale (VAS) scores was calculated for each patient during the procedure. Complications were graded according to modified Clavien classification system. Results: The mean age of patients was 50.58±13.04 years and BMI was 33.46±2.59 kg/m2. Mean stone size was 2.51±1.04 cm and operative time was 43.91±15.92 minutes. None of the patients had severe pain and the mean VAS score was calculated as 2.31±1.02. Mean length of hospital stay was 1.25±1.04 days. Grade 3 or higher complications were not observed according to modified Clavien classification system. Mean urethral catheterization time was 1.56±1.45 days, although varying due to underlying etiological factor. All patients were stone-free and there was a marked improvement in clinical findings. Conclusion: Use of HLL under local anesthesia is a safe and efficacious approach in obese male patients with bladder stone.

Surgery and Postoperative Care of Patients Undergoing Percutaneous Nephrolithotomy under the Guidance of B-Ultrasound Based on Smart Internet of Things

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