What is a cystoscopic litholapaxy?

A cystoscopic litholapaxy is a medical procedure used to treat bladder stones, which are hard deposits of minerals that can form inside the bladder.

During a cystoscopic litholapaxy, an instrument called a cystoscope is inserted into the bladder to locate the bladder stone or stones.

The cystoscope is a long, narrow tube with a small camera at one end. The cystoscope is connected to a stone-crushing device, which uses laser energy or ultrasound waves to break up the stones into smaller fragments.

What are the types of cystoscopic litholapaxy procedures?

There are 2 different cystoscopic litholapaxy procedures, as described below:

Transurethral cystoscopic litholapaxy

This is the surgical procedure used most often to treat bladder stones in adults. It is performed under general or local anesthesia.

The cystoscope is inserted into the bladder through the urethra. Laser or ultrasonic waves are transmitted through it to crush the stones into smaller pieces. A mechanical crushing device may be used instead. The remaining fragments may be washed out of the bladder with fluids.

Percutaneous suprapubic cystoscopic litholapaxy

This procedure is used in cases where transurethral cystolitholapaxy would not be suitable or effective. The surgery is performed under general anesthesia.

The procedure requires 2 cuts to be made: 1 cut in the skin of the lower abdomen and another cut in the wall of the bladder. The cystoscope is then inserted through the incisions and the stones are broken up with a laser or ultrasound waves.

Percutaneous suprapubic cystoscopiclitholapaxy is the preferred method when treating children with bladder stones. The urethra is narrower in children and it is more difficult to insert a cystoscope. This technique is also used for adults with large bladder stones.

What are the complications of cystoscopic litholapaxy?

Urinary tract infections are the most common complication associated with a cystoscopic litholapaxy. About 1 in 10 people develop urinary tract infections (UTIs) after bladder surgery. UTIs may be treated with antibiotics.

In rare cases, perforation (tearing) of the bowel may occur during a percutaneous suprapubliccystoscopiclitholapaxy.

Delayed scar formation in the urethra or bleeding is other rare complications. Other possible complications associated with any type of surgery may occur, including the formation of blood clots in the lungs or legs, infections, or bleeding.

What should a patient expect after a cystoscopic litholapaxy?

A catheter may be inserted into the urethra or bladder to drain urine from the body after the operation. It will usually remain in place for 24 to 48 hours, but the amount of time may vary.

The patient may feel discomfort while passing urine for 2 or 3 days after returning home. The patient may take medicine to relieve pain or discomfort. There may be a small amount of blood in the urine.

It may take several weeks to recover from a cystoscopic litholapaxy. The patient may have to take 3 to 4 weeks off from work, and even more time if the job requires physical activity or heavy lifting.