Retrograde-Assisted Percutaneous Cystolitholapaxy Versus Transurethral Cystolithotripsy With Holmium-YAG Laser: A Retrospective Study

Abstract

Introduction: The retrograde approach is a modification that makes the percutaneous cystolitholapaxy (PCCL) a more trendy method, especially in operating rooms with limited facilities. The transurethral approach for bladder calculi lithotripsy by a laser has become popular among urologists. In this study, we investigate the feasibility and safety of retrograde assisted access for PCCL in comparison with transurethral cystolithotripsy by the holmium-YAG laser (Ho: YAG). Methods: According to the type of intervention, the patients were stratified to two matched groups. In the retrograde-assisted percutaneous cystolitholapaxy (RPCCL) group, a Benique was conducted through the urethra into the bladder; palpating the suprapubic region, an about 1.5 cm incision was done over the tip, then an Amplatz sheath was placed over it, treading into the bladder; further cystolitholapaxy was done by a routine order. In transurethral Ho: YAG laser lithotripsy (TULL) via 200 µm fiber vaporize the stone. Results: A total of 124 male patients with the mean age of 50.33±9.64 years and the average stone burden of 3.35±1.07 cm were included in the study. The most common cause of vesical calculi was spinal cord injury. Statistically significant differences were found in terms of the mean operation time in favor of the RPCCL group (P≤0.05) and the mean hospital stay in favor of the TULL group (P≤0.05). The stone-free rate (SFR) was 100% in both methods after a onemonth follow-up. None of the interventions changed to open surgery. There were not any major complications in both methods. Conclusion: RPCCL is a safe and effective method in bladder stone treatment and is applicable in medical centres without Ho: YAG equipment.

Percutaneous resection of anteriorly located midline prostatic cyst: A case report and description of technique

“…Percutaneous approaches to treat different pathologies in the urinary tract have been described before. This approach has been used to treat large bladder stones and benign prostatic hypertrophy [ 9 , 10 ]. To our knowledge, this is the first description of its use to treat an anterior MPC.…”

Flexible cystoscopy and laser stone fragmentation via Mitrofanoff stoma: A case series

“…13,14 Endoscopic laser fragmentation via the Mitrofanoff stoma in these two cases offered an attractive alternative approach, with no postoperative wound complications and short hospitalisation. 11…”

“…With regards to the operative approach, although open and percutaneous procedures offer comparable stone-free rates to transurethral endoscopic procedures, the operative time, catheterisation time and length of hospital stay are significantly shorter for endoscopic procedures. [9][10][11][12] Patients with congenital or acquired abdominal wall defects can also develop problems with abdominal wall closure after surgery. Two of these patients had an acquired vesicocutaneous fistula following previous open or percutaneous cystolitholapaxy, which complicated future attempts at the same approach for the management of their recurrent bladder stones.…”

“…13,14 Endoscopic laser fragmentation via the Mitrofanoff stoma in these two cases offered an attractive alternative approach, with no postoperative wound complications and short hospitalisation. 11 This technique is another in the arsenal of an endoluminal endourologist, rather than a substitute for any particular procedure. Mitrofanoff cystolitholapaxy has been reported before in 2015 in the literature by Floyd et al, who useed an Add-A-Cath access sheath in a patient with spina bifida.…”

Application of Percutaneous Holmium Laser Lithotripsy in the Treatment of Bladder Calculi with Lower Urinary Tract Obstruction or Pelvic Joint Disease

“…Therefore, the establishment of a percutaneous bladder channel [5] with a method similar to that of percutaneous nephrolithotomy [6] can provide a new way for the surgical treatment of bladder calculi. From 2017 to 2019, 61 cases with bladder calculi combined with lower urinary tract obstruction or pelvic joint disease were successfully treated with percutaneous holmium laser lithotripsy.…”