What is a cystolitholapaxy?
A cystolitholapaxy is a surgical procedure used to treat bladder stones, which are hard deposits of minerals that can form inside the bladder. During a cystolitholapaxy, an instrument called a cystoscope is inserted into the bladder to locate the bladder stone or stones. The cystoscope is a like a tiny telescope. A laser is used to break up the stones into smaller fragments which are then removed.
What are the types of cystolitholapaxy procedures?
There are two different cystolitholapaxy procedures:
- Transurethral cystolitholapaxy: 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 and stones are removed.
- Percutaneous suprapubic cystolitholapaxy: 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 one incision (approximately 1cm) in the skin of the lower abdomen and a hollow tube (sheath) is placed through which the cystoscope is inserted and stones removed.
Percutaneous suprapubic cystolitholapaxy 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.
Risks / Benefits
What are the complications of cystolitholapaxy?
Urinary tract infections are the most common complication associated with a cystolitholapaxy. 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 suprapublic cystolitholapaxy. Delayed scar formation in the urethra or bleeding are other rare complications. Other possible complications associated with any type of surgery may occur, including formation of blood clots in the lungs or legs, infections or bleeding.
Recovery and Outlook
What should a patient expect after a cystolitholapaxy?
A catheter may be inserted into the urethra or bladder to drain urine from the body after the operation. It usually remains in place for 24 to 48 hours, but the amount of time may vary. You may feel discomfort while passing urine for two or three days after returning home. There may be a small amount of blood in the urine. It’s OK to take medicine to relieve pain or discomfort.
It may take about a week to recover from a cystolitholapaxy. Plan to take one to two weeks off work, and more time if your job requires physical activity or heavy lifting.
Drink plenty of water while you’re recovering. Try to drink about eight glasses of water or liquids per day.
Contact your doctor if you:
- Develop a fever.
- Have severe pain while urinating.
- Have heavy bleeding.
- Can’t pass urine.
What is the outlook for patients after a cystolitholapaxy?
You should schedule a follow-up appointment with your doctor about a month after the procedure. X-rays or a CT scan may be performed to ensure that the bladder stones have been completely removed. Some patients may need to undergo another surgical procedure called an open cystotomy, if the cystolitholapaxy was not successful in removing the bladder stones.
Bladder stones can come back unless the underlying condition that caused them is treated. Discuss possible treatment options with your doctor.
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