Electrohydraulic Lithotripsy with Aspiration of the Fragments Under Vision—304 Consecutive Cases

Abstract

We herein report on 304 consecutive cases of bladder stones treated by electrohydraulic lithotripsy. The special armamentarium is described. The average age for male patients was 68.5 years, the oldest being 102 years, and for female patients it was 63.9 years. Of the patients 38.5 per cent were high risk. The weight of the transurethrally removed stones ranged from 1 to 135 gm. In 70.4 per cent of the male patients transurethral resection of the prostate was done under the same anesthesia and technical problems were encountered in 12 operations (4 per cent). Bladder perforations occurred in 5 patients but cystotomy and drainage were necessary in only 1 (0.3 per cent).

Minimally Invasive Surgery for Patients with Bulky Bladder Stones and Large Benign Prostatic Hyperplasia Simultaneously: A Novel Design

“…The most important one is their insufficiency to pin the fragment when large stones are disintegrated into smaller pieces, and surgeons often exert time and energy to search and chase the fragments via changing the irrigating flow intermittently, particularly when distinct trabecula and diverticula usually caused by BOO are present. Secondly, it is quite common that the lithotripter probe or laser fiber damage the bladder wall even causing perforation during the lithotripsy [16]. Sometimes the bladder stones have to be pushed against the bladder wall by the probes when fragmenting, mucosa injury cannot be absolutely avoided, and the tiny residual fragments could be attached into the mucosa.…”

Percutaneous Cystolithotripsy in Pediatric Bladder Stone: Case Report

“…Equipment availability in relevant centre is quite important in the choice of treatment that will applied with patient and stone characteristics. Percutaneous cystolithotripsy eliminates stones rapidly, especially bigger bladder stone in childhood than transurethral approach and percutaneous approach has some advantages such as wide working channel, rapidly stone removing, better visualization, lower complication and smaller operation time [5][6][7]. Especially when trying to actively remove residual fragments, useful of transurethral approach for large bladder stones can entail a prolonged and cumbersome procedure.…”

Comparison of Transurethral use of Nephroscope with Cystoscope in Transurethral Cystolithotripsy

“…Transurethral intervention in TUCL is generally performed by a cystoscope. This approach permits the use of various devices such as mechanical stone crusher, electrohydraulic, ultrasonic, pneumatic and laser lithotripters [2,3,6,21]. Transurethral treatment of large and/or multiple bladder stones by the cystoscope can be time consuming because different lithotripters can be used and manuplation has the potential to cause urethral injury especially during the active removal of residual fragments [22].…”

“…Bladder stones, generally affecting men, account for 5% of urinary stones and usually occur because of bladder outlet obstruction (BOO), neurogenic voiding dysfunction, infection or foreign bodies [1][2][3]. Mixed types constitute the most common form of bladder stones [4].…”