A cystolitholapaxy is a medical 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 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.
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.
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.
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. You may feel discomfort while passing urine for 2 or 3 days after returning home. You 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 cystolitholapaxy. You may have to take 3 to 4 weeks off of work, and even more time if your job requires physical activity or heavy lifting.
You should drink plenty of water while you are recovering. It is recommended that you drink about 8 glasses of water or liquids per day.
Contact your doctor if you:
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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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 03/03/2017