Cystolitholapaxy Surgery

Overview

Cystolitholapaxy is a minimally invasive surgical procedure to break down and remove bladder stones. These stones form due to the accumulation of minerals in the bladder or can travel from the kidney, leading to discomfort and pain during urination. A cystoscope, along with lasers or ultrasonic waves, is used to fragment and remove these stones effectively.

Alternate Name

Scientific name: Cystolitholapaxy

Body Location

Urinary bladder

Types of Cystolitholapaxy

Transurethral Cystolitholapaxy: A minimally invasive approach through the urethra.
Percutaneous Cystolitholapaxy: Involves small incisions in the bladder and abdomen.

Preparation for Cystolitholapaxy

Tests Before Surgery:

ECG to monitor heart activity.
Blood tests, including hemoglobin levels, blood group, liver, and kidney function.
Urine tests to detect high mineral levels or infections.
Imaging such as ultrasounds and CT scans to confirm the presence and location of stones.

Preparation Steps:

Routine tests are performed a few days before surgery.
Discontinue medications like aspirin a week prior.
Overnight fasting before the procedure.
Informed consent is required.

Anesthesia:

General or spinal anesthesia for transurethral cystolitholapaxy.
General anesthesia for percutaneous cystolitholapaxy.

How Cystolitholapaxy Surgery is Performed

The cystoscope is used to access the bladder and break down stones through one of two approaches:

Transurethral Cystolitholapaxy:
- The cystoscope is introduced through the urethra.
- Lasers or ultrasound waves are used to fragment the stones.
- Fragments are removed using suction and irrigation.
- This approach does not require surgical incisions, resulting in faster recovery and less post-operative pain.
Percutaneous Cystolitholapaxy:
- The cystoscope is introduced through small incisions in the abdomen and bladder.
- Stones are fragmented and removed, similar to the transurethral method.
- This technique is suitable for patients with narrow urethras or large bladder stones but has a longer recovery period due to greater post-operative discomfort.

A Foley catheter is placed in the urethra after the procedure to drain urine.

Risks Associated with Cystolitholapaxy

Possible risks include:

Burning sensation during urination.
Urinary tract infections (prevented with antibiotics).
Bladder perforation.
Bleeding.
Frequent urination or difficulty passing urine.
Urethral tissue damage, leading to scar formation.
Stone recurrence or incomplete removal, potentially requiring open surgery.
General surgical complications, including deep vein thrombosis.

Recovery After Cystolitholapaxy

Daily Activities:

Gentle walks to prevent blood clots.
Vigorous activities can be resumed within 2–5 days post-surgery.
Showers are allowed after catheter removal.

Diet:

No special dietary restrictions post-surgery.

Work:

Patients can typically return to work within 2–3 days, avoiding heavy lifting for 1–2 weeks.

Medications:

Antibiotics are prescribed to prevent infections.

Catheter:

The Foley catheter is usually removed 24–48 hours after surgery.

Follow-Up:

A re-examination is advised 4–6 weeks post-surgery to ensure proper recovery.

Cystolitholapaxy is a safe and effective procedure with minimal downtime, offering relief from bladder stone-related symptoms with proper care and follow-up.

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