What are the types of cystolitholapaxy procedures?

There are 2 different cystolitholapaxy procedures, as described below:

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. 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 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 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 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.

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