Cystolitholapaxy

Overview

Cystolitholapaxy is a surgical procedure used to treat bladder stones, which are solid mineral deposits that can develop in the bladder. In this procedure, a surgeon inserts a cystoscope—a tube equipped with a camera—into the bladder to locate the stones. Using a laser, the stones are fragmented into smaller pieces, which are then extracted. This outpatient procedure typically allows patients to return home the same day and can be performed under either local or general anesthesia.

Types of cystolitholapaxy procedures

Cystolithapaxy can be performed in two ways:

• Transurethral cystolitholapaxy: This surgical procedure is the primary method used by doctors to treat bladder stones. It involves inserting a cystoscope through the urethra into the bladder to locate the stones. The stones are then broken into smaller pieces using a laser or ultrasound device before being removed.
• Percutaneous suprapubic cystolitholapaxy: Healthcare providers opt for this approach when treating children with bladder stones due to narrower urethras, which make cystoscope insertion challenging. It is also utilized for adults with larger bladder stones. The procedure involves making one incision in the lower abdomen and another in the bladder to access and remove the stones.

Risks

In general, cystolitholapaxy is a safe and efficient technique. Urinary tract infections (UTIs) are the most frequent complication following a cystolitholapaxy. After bladder surgery, approximately 10% of patients experience UTIs. UTIs are cured by antibiotics.

Other infrequent but potential side effects consist of:

• Excessive bleeding.
• Blood clots in the lungs or legs.
• Recurrence of bladder stones
• The development of scar tissue in your urethra.
• Reactions to anesthesia

Before the procedure

You will receive instructions from your doctor on how to get ready for surgery. These could contain guidelines regarding:

• Which drugs should be discontinued in the days preceding surgery. Make sure your surgeon is aware of any daily drugs you take. A prescription should not be stopped unless your doctor instructs you to.
• The appropriate time to quit drinking and eating. The majority of doctors advise you to fast the night before operation.
• Making plans for a trip home or for post-operative care at home during the initial hours.

During the procedure

Before the procedure, your doctor will administer anesthesia to ensure you are pain-free. This can be either general anesthesia, which induces unconsciousness, or local anesthesia, which numbs the area without causing unconsciousness.

Surgeons utilize a minimally invasive technique known as cystolithopapaxy to remove bladder stones. A cystoscope, a long, thin tube with a camera at its end, is inserted by the doctor into the bladder and urethra. This allows the surgeon to precisely locate the bladder stones. The stones are then fragmented into small pieces using a laser. Finally, the stones are flushed out of the bladder with fluids.

The procedure typically lasts between thirty to sixty minutes. Afterward, you will recover in a designated area before being discharged home on the same day.

After the procedure

Certain symptoms following a cystolitholapaxy are normal. Following surgery, you should anticipate the following throughout the first 72 hours:

• Blood or tiny clots of blood in your urine.
• Urine that contains tiny stones.
• A burning feeling after urinating.

Find out from your doctor when to worry and what’s typical following the surgery. Due to the residual anesthesia in your system, it is best to abstain from alcohol, drive or operate heavy machinery, or sign any crucial documents within the first 24 hours following surgery.

After surgery, some patients can have a catheter in their bladder to aid with urination. This tube collects urine from your bladder and moves it to an external bag that you wear on your body. While your body heals, it might remain in place for up to a week. After that, your physician will take it out.

Other guidelines for self-care could be:

• Take acetaminophen or ibuprofen for mild discomfort as directed on the label.
• Drink lots of water following surgery. If the pain is unbearable or doesn’t go better, get in touch with your doctor.
• If your doctor recommends antibiotics, take them as directed to avoid infection.
• During the first 24 to 48 hours, give yourself some relaxation.

Outcome

The majority of patients recover completely in two weeks. When you go back home, you can resume your regular eating and drinking schedule. After surgery, your doctor will advise you to take a stroll. Your legs may not clot with blood if you do this.

Additionally, your doctor might suggest the following:

• For pain, take acetaminophen. Painkillers with a prescription may be recommended by your physician. Adhere to the directions on the prescription.
• Following surgery, it is safe to walk and use the stairs. Cease the activity if it causes you pain.
• Following surgery, you can take a normal shower or bath.
• Steer clear of intense or demanding exercise for a couple of weeks.
• For two weeks, avoid lifting anything more than ten pounds.
• If you have problems with bowel movements following surgery, use a stool softener. Constipation is a side effect of anesthesia.

Your doctor will schedule a follow-up appointment typically within one to two weeks after surgery. During this visit, if you were discharged with a catheter, your doctor will arrange for its removal.

To ensure the bladder stones are completely resolved and to check for any recurrence, your doctor may order CT scans or X-rays. Addressing the underlying cause of bladder stones is crucial to prevent them from coming back.

Most people can return to work or school within two to three days, although this timeframe can vary depending on the nature of your job. After 14 days, you can generally resume activities like lifting heavy objects, exercising, and participating in sports. It’s important to consult with your doctor for personalized guidance based on your specific situation.