Safety and efficacy of cystoscopy guided percutaneous suprapubic cystolithotomy using suprapubic laparoscopic port without fluoroscopic guidance

DR. SHARAD M. PATEL; DR. NAMAN K. PATEL; DR. SANJAY KARANGIYA; DR. DHRUVESH SHETH; DR. SHUBHAM PATEL

Volume : VIII, Issue : XII, December - 2019

Safety and efficacy of cystoscopy guided percutaneous suprapubic cystolithotomy using suprapubic laparoscopic port without fluoroscopic guidance

Dr. Sharad M. Patel, Dr. Naman K. Patel, Dr. Sanjay Karangiya, Dr. Dhruvesh Sheth, Dr. Shubham Patel

Abstract :

Objective: To evaluate the safety and efficacy of percutaneous cystolithotomy(PCCL) using suprapubic laparoscopic port under cystoscopic guidance and without fluoroscopy for the management of bladder stones. Patients and methods: Prospectively collected data were reviewed for patients undergoing PCCL with cystoscopic guidance suprapubic laparoscopic port without fluoroscopy. Patients with a bladder stone of less than 20 mm were included. Stone was removed from urinary bladder with suprapubic 10mm laparoscopic port using stone holding forceps. Patients with concomitant bladder malignancy, previous pelvic radiotherapy, previous pelvic–abdominal surgery, or benign prostate enlargement of >80 mL were excluded from the study. Results: In all, 30 male patients were included between June 2017 and June 2019 with a mean (SD) age of 36.9 (17.6) years. A single bladder stone was detected in 25 (83%) patients, while 5 (17%) had multiple bladder stones, with a mean (range) stone size of 15 (10–20) mm. The stone–free rate was 100% and the procedure was well tolerated by all patients. No intraoperative bladder perforation, bleeding or major perioperative adverse events were recorded. The mean (SD) hospital stay was 2.2 (0.41) days and the catheterisation time was 1.2 (0.6) days. At 4 weeks postoperatively, no significant stone fragments were found in any of the patients. Conclusion: PCCL under cystoscopic control and without fluoroscopy seems to be an effective and safe technique to remove single/multiple bladder calculi. It represents an alternative treatment option, especially in situations where fluoroscope is not available, and radiation hazards can be avoided.