What is a cystolitholapaxy?
A cystolitholapaxy is a surgical procedure done to treat bladder stones. Bladder stones are hard deposits of minerals that can form inside the bladder. During a cystolitholapaxy, a tool known as cystoscope is inserted into the bladder to trace the bladder stone(s). A 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.
Types of cystolitholapaxy procedures
There are two different cystolitholapaxy procedures:
Transurethral cystolitholapaxy: This is the surgical procedure used regularly to treat bladder stones in adults. It is carried out under general or local anesthesia. The cystoscope is put into the bladder through the urethra. Laser or ultrasonic waves are transmitted through it to crush the stones into smaller pieces. A mechanical crushing tool may be used instead. The remaining fragments may be washed out of the bladder with fluids.
Percutaneous suprapubic cystolitholapaxy: This surgical procedure is used in cases where transurethral cystolitholapaxy would not be suitable. The surgery is carried out under general anesthesia. The surgical procedure requires two cuts to be made: one incision in the skin of the lower abdomen and another incision in the wall of the bladder. The cystoscope is then inserted through the incisions and the stones are broken up with ultrasound waves.
Percutaneous suprapubic cystolitholapaxy is the preferred surgical procedure when treating children with bladder stones. The urethra is narrower in children and it is more difficult to insert a cystoscope. This method is also used for adults with large bladder stones.
Complications of cystolitholapaxy
The most common complication associated with a cystolitholapaxy are urinary tract infections. About one in ten people develop urinary tract infections (UTIs) after bladder surgery. UTIs may be treated with antibiotics.
In rare cases, tearing of the bowel may occur during a percutaneous suprapublic cystolitholapaxy. Other rare complications are delayed scar formation in the urethra or bleeding. Other possible complications associated with any type of surgery may occur, such as formation of blood clots in the lungs or legs, infections or bleeding.
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 surgical operation. It will normally 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 medication to relieve pain or discomfort. There may be a small amount of blood in the urine.
It may take several weeks to recuperate from a cystolitholapaxy. You may have to take two to four weeks off from work, and even more time if your job involves physical activity or heavy lifting.
Drink plenty water while you are recovering. It is recommended that you drink about eight glasses of water per day.
Contact your doctor if you:
- Develop a fever.
- Have severe pain while urinating.
- Have heavy bleeding.
- Cannot pass urine.
Outlook for patients after a cystolitholapaxy
Schedule a follow-up appointment with your doctor about a month after the surgical procedure. X-rays or a CT scan may be done to ensure that the bladder stones have been completely removed. Some patients may need to go through 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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