Cystolitholapaxy (Removal of Bladder Stones)
Why cystolitholapaxy?
Most bladder stones can be dealt with by an endoscopic (telescope) procedure, to avoid the need for a surgical incision. If stones are very large, it is often best to perform an open operation. These options will be discussed with you before surgery.
Stones form in the bladder for a variety of reasons. In men, the most common cause is bladder outflow obstruction from an enlarged prostate. This can be dealt with at the same time, although with large stones there may be an increased risk of infection, and it may be best to remove the stone first, and address the prostate issue at a later date. This will be discussed with you if relevant.
How is the operation done?
Endoscopic removal is performed under general anaesthetic as an inpatient procedure. The first step is a cystoscopy. Once the bladder has been examined, a similar, but slightly larger, telescope is inserted through the urethra to the bladder. Stones are broken into small fragments by a laser passed down the telescope. Occasionally, the stone is broken with crushing forceps rather than laser.
The fragments are then removed via the telescope, and a catheter is inserted into the bladder. This allows fluid to be gently washed in and out of the bladder for a period of time, as there is often some bleeding as a result of the stone rubbing against the bladder lining.
After the operation
Most patients will stay in for at least one night after the operation, and the catheter can be removed when the urine is clear. You will be discharged when fit, and will be advised to rest at home for a few days. Specific advice will be given on discharge.
Potential side effects and complications
All procedures have the potential for side effects. Although these complications are well recognised, the majority of patients do not have problems after a procedure.
There are specific risks with this surgical procedure, and these will be discussed with you before your procedure. As a guide to complement that one-on-one discussion with your surgeon, these include:
Common
- A burning sensation and/or a small amount of blood in the urine for a short period afterwards
Occasional
- Infection of the bladder requiring antibiotics
- Failure to clear all of the stone
Rare
- Temporary insertion of a new catheter if you are unable to pass urine immediately after the first one is removed
- Delayed bleeding requiring removal of clots or further surgery Injury to the urethra causing delayed scar formation
- Fever and more serious infection requiring a longer hospital stay
If you develop a fever, severe pain on passing urine, inability to pass urine or worsening bleeding, you should contact the practice immediately. If out of hours, please go to your nearest emergency department.
Disclaimer
This information is intended as an educational guide only, and is here to help you as an additional source of information, along with a consultation from your urologist. The information does not apply to all patients.
Not all potential complications are listed, and you must talk to your urologist about the complications specific to your situation.
