Outpatient Transurethral Cystolithotripsy of Large Bladder Stones by Holmium Laser

Abstract

Introduction: To assessment of the efficacy and safety of transurethral cystolithotripsy of large bladder stones by holmium laser in the outpatient setting. Methods: In a prospective study, 48 consecutive adult patients with large bladder stones, were enrolled for transurethral cystolithotripsy. Patients older than 18 years, with bladder stones larger than 2 cm were enrolled. Urethral stricture, active urinary infection, and any anesthetic contraindications for operation, were the exclusion criteria. Demographic characteristics of patients, outcomes and complications related to operation and post operation period, were recorded. Results: Patients mean age was 46 ± 7.3 years. Male to female ratio was 45/3. Mean body mass index of patients was 28.5 ± 3.5. Mean stone size was 3.7 ± 1.6 cm. Mean operation time was 43.5 ± 15.5 minutes. Nearly complete stone clearance (98.5%) was achieved in all patients. Mean hospital stay was 6.5 ± 1.3 hours. No major complications were seen. Mean visual analog pain score (VAS) was 4.2 ± 2.1 and 1.4 ± 0.6, during and 1 hour after operation, respectively. During follow up of 22.4 ± 12.5 months, recurrence of bladder stone was not seen. No case of urethral stricture was detected. Conclusion: Transurethral holmium laser lithotripsy is an effective and safe alternative in selected patients with large bladder stones. This procedure can be easily performed in the outpatient setting.

Laser Application in Iran Urology: A Narrative Review

“…Major complications and recurrence of bladder stone were not seen. 42 Another study was about the safety and efficacy of laser lithotripsy in pregnancy reported by Abedi et al In this retrospective study, 15 pregnant women with ureteral stones treated with semi-rigid ureteroscope and holmium laser were included. They concluded that laser lithotripsy is a safe method in pregnant patients with ureteral stone where conservative treatment failed.…”

Intraperitoneal Bladder Stones Following Transurethral Cystolithotripsy: A Case Report

“…Transurethral cystolithotripsy (TUCL) is the choice of current interventions for bladder stones in adults and children [1,2]. Although it has the same e cacy as percutaneous cystolithotripsy (PCCL) and shorter hospital stay than PCCL, complications could occur [1,[3][4][5]. A rare complication of bladder rupture with stone slipping out would be encountered.…”

Endoscopic intact removal of medium-size- or multiple bladder stones with the use of transvesical laparoendoscopic single-site surgery

“…Excellent results of outpatient transurethral cystolithotripsy of large bladder stones was presented by Karami et al in 2016. In their study, the mean time of hospital admission of patients was 6.5 h [ 4 ]. In the study by Kara et al describing transurethral cystolithotripsy with a Holmium laser under local anesthesia, the mean hospital stay was 2.3 days [ 17 ].…”

“…There are numerous index procedures for cystolithiasis, either transurethral or percutaneous; but, open surgery remains the only way to remove the majority of larger stones intact, although it causes the most morbidity. Less morbid endoscopic treatment modalities are afflicted by the potential for incomplete stone clearance [ 4 , 5 ]. The use of shockwave lithotripsy (SWL) provides the minimal morbidity, with up to 90% effectiveness; but, in one-third of the patients, additional procedures are required [ 1 , 6 ].…”