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Chapelle C, Lavallée E, Vallée M, Descazeaud A. Bicentric retrospective study comparing the postoperative outcomes of patients treated surgically for bladder stones with or without concomitant surgery for BPH. World J Urol 2024; 42:13. [PMID: 38189811 DOI: 10.1007/s00345-023-04699-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/10/2023] [Indexed: 01/09/2024] Open
Abstract
PURPOSE To compare the postoperative outcomes of male patients who underwent bladder stone (BS) removal, with or without concomitant benign prostatic hyperplasia (BPH) surgery. PATIENTS AND METHODS All men aged > 50 years who underwent BS removal at two French university hospitals between 2009 and 2018 were retrospectively reviewed. Four binary outcome criteria were identified during the follow-up: early postoperative complications, stone recurrence, subsequent surgery for BS or BPH, and late surgical complications. A composite score ranging from 0 to 4 was calculated by combining the four criteria. RESULTS A median follow-up period of 42 months was observed in 179 patients. Of these, 107 patients were in the "concomitant surgical treatment" (CST) group and 72 in the bladder "stone removal alone" (SRA) group. The CST group presented higher baseline post-void residual volume (105 vs. 30 ml, p = 0.005). Patients who underwent CST had a significantly lower rate of BS recurrence (12% vs. 39%; p = 0,001) and underwent fewer subsequent surgeries (14% vs. 44%; p < 0.001). There was no significant difference in the early (51% vs. 35%, p = 0,168) and late (26% vs. 17%, p = 0,229) complications rates between the two groups. A better composite score was observed in the CST than in the SRA, but the difference was not significant (3.07 vs. 2.72, p = 0.078). CONCLUSION As CST increases morbidity and decreases the risk of reoperation, each situation should be considered, taking into account patient choice and comorbidities.
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Affiliation(s)
- Caroline Chapelle
- CHU La Milétrie, Service d'Urologie Et de Transplantations Rénales, CHU de Poitiers, 2 Rue de La Milétrie, 86021, Poitiers, France.
| | - Etienne Lavallée
- Service de Chirurgie Urologique CHU de Québec - Hôtel-Dieu de Québec, 11 Côte du Palais, Québec, QC, G1R 2J6, Canada
| | - Maxime Vallée
- CHU La Milétrie, Service d'Urologie Et de Transplantations Rénales, CHU de Poitiers, 2 Rue de La Milétrie, 86021, Poitiers, France
| | - Aurélien Descazeaud
- Service de Chirurgie Urologique, CHU de Limoges, 2, Avenue Martin-Luther-King, 87042, Limoges, France
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Maresca G, Mc Clinton S, Swami S, El‐Mokadem I, Donaldson JF. Do men with bladder stones benefit from treatment of benign prostatic obstruction? BJU Int 2022; 130:619-627. [PMID: 35482471 PMCID: PMC9790555 DOI: 10.1111/bju.15761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To identify whether men aged ≥40 years with bladder stones (BS) benefit from treatment of benign prostatic obstruction (BPO). PATIENTS AND METHODS A regional, retrospective study of patients undergoing BS surgery between January 2011 and December 2018 was performed using a prospectively collected database. The primary outcome was BS recurrence after successful removal. Kruskal-Wallis and chi-squared statistical tests were used. RESULTS A total of 174 patients underwent BS removal and 71 (40.8%) were excluded due to BS formation secondary to causes other than BPO. Hence, 103 men aged ≥40 years had BS successfully removed, of which 40% had a history of upper tract urolithiasis. These men were divided into three groups: those undergoing contemporaneous medical, surgical, or no BPO treatment. Age, diabetes, previous urolithiasis and previous BPO surgery were well matched between the BPO treatment groups. In all, 18 of these men (17%) had BS recurrence after 46 months follow-up. Recurrences were significantly lower following BPO surgery; one of 34 (3%) men versus five of 28 (18%) with no BPO treatment (P = 0.048) and 12 of 41 (29%) with medical BPO treatment (P = 0.003). Recurrences after medical and no BPO treatment were similar (P = 0.280). In all, 34 men (33%) had BPO complications that were similar between groups (P = 0.378). CONCLUSION This is the largest reported cohort of men, with the longest follow-up after BS removal. Most men aged ≥40 years with BS benefit from BPO surgery. However, the study findings also support a multifactorial aetiology for BS, which questions the dogma that BS are an 'absolute indication' for BPO surgery, as is stated in the Non-neurogenic Male Lower Urinary Tract Symptoms European Association of Urology Guideline. Assessment and management of all causative factors is likely to enable selection of which men will benefit from BPO surgery and to reduce BS recurrence rates.
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Affiliation(s)
- Gianluca Maresca
- Department of UrologyAberdeen Royal Infirmary – NHS GrampianAberdeenUK,Academic Urology Unit (AUU)University of AberdeenAberdeenUK
| | - Samuel Mc Clinton
- Department of UrologyAberdeen Royal Infirmary – NHS GrampianAberdeenUK,Academic Urology Unit (AUU)University of AberdeenAberdeenUK
| | - Satchi Swami
- Department of UrologyAberdeen Royal Infirmary – NHS GrampianAberdeenUK,Academic Urology Unit (AUU)University of AberdeenAberdeenUK
| | - Ismail El‐Mokadem
- Department of UrologyAberdeen Royal Infirmary – NHS GrampianAberdeenUK,Academic Urology Unit (AUU)University of AberdeenAberdeenUK
| | - James F. Donaldson
- Department of UrologyAberdeen Royal Infirmary – NHS GrampianAberdeenUK,Academic Urology Unit (AUU)University of AberdeenAberdeenUK
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Shalaby EA. Assess the safety and effectiveness of a novel approach during transurethral pneumatic cystolithotripsy in large urinary bladder stone: quasi-clinical trial. Urolithiasis 2021; 50:189-197. [PMID: 34853892 DOI: 10.1007/s00240-021-01294-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/19/2021] [Indexed: 11/24/2022]
Abstract
To assess the safety and efficacy of using continuous irrigation-modified hysteroscopy during transurethral pneumatic cystolithotripsy for large bladder calculi. A prospective study was carried out from May 2016 until March 2020. All patients with solitary or multiple bladder stones > 2.5 cm were subjected to Transurethral pneumatic cystolithotripsy using a modified continuous irrigation hysteroscopy, the stone fragments were removed by Ellik Evacuator, the safety and effectiveness of the procedures were evaluated, stone-free rate (SFR), stone recurrence and stricture urethra disease during follow-up. 55 patients with a mean age of 57.36 (22-82) years were included, the male: female ratio was 4:1, single stone in 74.5% and the mean stone size was 52 mm. Lithotripsy time and an operative time were (20.39 ± 3.06 and 32.00 ± 3.57) minutes, respectively. Mean hospital stay was 10 ± 3.6 h. This endoscopic technique succeeded with a 100% SFR. During the 22 months of follow-up, no urethral stricture or stone recurrence was documented. The mean visual analog pain score (VAS) was 4.2 ± 2.1 and 1.4 ± 0.6, respectively, during and after the operation. The use of the modified hysteroscopy sheath during transurethral pneumatic cystolithotripsy is safe and effective for the management of large urinary bladder stones, an alternative to holmium laser in developing countries when laser equipment is unavailable. Comparable to other transurethral maneuvers, with a decrease in the risk of urethral stricture disease due to the small caliber of the device, as there is no urethral dilatation is required.
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Affiliation(s)
- E A Shalaby
- Department of Urology, Suez Canal University, Ismailia, Egypt.
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Synchronous transurethral cystolitholapaxy and TURP reveals better results than transurethral cystolitholapaxy plus medical therapy for BPH: a randomized prospective study on 100 patients with concomitant urinary bladder stone(s) and BPH. World J Urol 2021; 40:483-487. [PMID: 34807286 DOI: 10.1007/s00345-021-03882-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE This report presents the results of a randomized prospective study comparing synchronous transurethral cystolitholapaxy and transurethral resection of the prostate (TURP) with transurethral cystolitholapaxy plus medical treatment for benign prostatic hyperplasia (BPH) in patients with concomitant vesical stone(s) and BPH. PATIENTS AND METHODS The study included 100 patients with bladder stone(s) < 2.5 cm associated with BPH. Eligible patients were divided randomly into two groups: group I (n = 50 patients) underwent simultaneous transurethral cystolitholapaxy and TURP, and group II (n = 50 patients) underwent transurethral cystolitholapaxy and received postoperative tamsulosin plus finasteride. RESULTS The mean follow-up was 20.1 ± 5.3 months. No statistically significant differences were found between the 2 groups regarding the preoperative parameters (age, prostatic volume, bladder stone characteristics, prostate-specific antigen level, International Prostate Symptom Score, peak urinary flow rate, and post-void residual urine volume). Both groups experienced statistically significant postoperative improvement in IPSS, post-void residual (PVR) urine volume, and peak flow rate compared with the preoperative parameters (P < 0.001 for all parameters). However, patients in group 1 had a more pronounced improvement (P < 0.001 for all parameters). Thus, 15 patients in group 2 underwent TURP during follow-up. PVR urine and prostate volume predicted the failure of medical therapy and the need for TURP. CONCLUSION Synchronous transurethral cystolitholapaxy and TURP revealed better results than transurethral cytolitholapaxy plus medical therapy. Cystolitholapaxy without TURP should not be indicated especially in patients with significant PVR urine volumes and larger prostates.
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KÖLÜKÇÜ E, PARLAKTAŞ BS, KÖLÜKÇÜ V, SARIKAYA K, ŞENOCAK Ç, BOZKURT ÖF. Our experience of laser lithotripsy under local anesthesia in the treatment of bladder stones in obese male patients. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.902684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Mekke S, Roshani H, van Zanten P, Palacios LG, Egberts J, Hendriks N, Wijffelman M, Zonneveld W, Merks B, van Loopik S, Buddingh T. Simultaneous transurethral resection of the prostate and cystolithotripsy: A urological dilemma examined. Can Urol Assoc J 2021; 15:E361-E365. [PMID: 33382366 DOI: 10.5489/cuaj.6743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Controversy exists over whether transurethral resection of the prostate (TURP) in men with bladder stones prevents recurrence of stone formation and facilitates stone discharge. We sought to evaluate whether TURP in patients who underwent cystolithotripsy led to a lower recurrence of bladder stones for which a re-cystolithotripsy was necessary. METHODS Patients (n=127) who underwent transurethral cystolithotripsy with (n=38) or without simultaneous TURP (n=89) between January 2009 and December 2013 were retrospectively included in five centers in the Netherlands. Median followup was 48 months. The primary endpoint was to compare the relative risk between both groups for re-cystolithotripsy due to recurrent bladder stones. Secondary outcomes were the relative risk of urinary retention, the need for a (re-)TURP and the average time until recurrence. RESULTS Patients who underwent a cystolithotripsy with a simultaneous TURP had a lower need for re-cystolithotripsy, resulting in a risk reduction of 72%. (relative risk [RR] 0.28 [0.07-1.13], p=0.06, number needed to treat [NNT]=7). The length of in hospital stay (3.4 vs. 1.6 days, p=0.04) and operative time (58 vs. 33 minutes, p<0.01) was longer when a TURP was performed. There was no significant difference in complication rate, occurrence of urinary retention, re-TURP, and re-admission. Eighty-one percent of patients who did not undergo a TURP remained free of bladder stone recurrence. Due to the retrospective nature of the study, essential data concerning prostate volume and micturition analysis was lacking. CONCLUSIONS A simultaneous TURP in patients who underwent a cystolithotripsy showed a trend towards a protective effect on the need for re-cystolithotripsy.
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Affiliation(s)
- Sander Mekke
- Department of Urology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Hossain Roshani
- Department of Urology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Paul van Zanten
- Department of Urology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | | | - Joost Egberts
- Department of Urology, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands
| | - Nora Hendriks
- Department of Urology, Alrijne Health Care Group, Leiden/Leiderdorp, The Netherlands
| | - Mischa Wijffelman
- Department of Urology, Alrijne Health Care Group, Leiden/Leiderdorp, The Netherlands
| | - Willemijn Zonneveld
- Department of Urology, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands
| | - Bob Merks
- Department of Urology, Haaglanden Medisch Centrum, Den Haag, The Netherlands
| | - Sarah van Loopik
- Department of Urology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Tim Buddingh
- Department of Urology, Haga Teaching Hospital, The Hague, The Netherlands
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Prise en charge de l’obstacle sous vésical lié à une HBP chez les patients à terrain particulier et/ou ayant une complication. Prog Urol 2018; 28:868-874. [DOI: 10.1016/j.purol.2018.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 12/25/2022]
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Torricelli FCM, Chueh SCJ, Shen S, Monga M. Multiple Uric Acid Bladder Stones: Clinical Presentation and Endoscopic Management. J Endourol Case Rep 2017; 3:21-23. [PMID: 28265592 PMCID: PMC5314972 DOI: 10.1089/cren.2016.0134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Bladder urinary calculi occur in 3%–8% of men with bladder outlet obstruction, and although most of them are composed of calcium, in a few cases uric acid bladder stones are diagnosed. Case Presentation: We present clinical images and therapeutic management of a 65-year-old diabetic man with significant prostate enlargement and >30 bladder stones, the largest being 17 mm. Despite the large stone burden, the patient was managed by cystolithotripsy. Remarkably, stone composition analysis revealed 100% uric acid stone. Intraoperative and postoperative course were uneventfully. Conclusion: Uric acid bladder stone pathogenesis seems to be multifactorial with local and systemic factors contributing in different manners and even large stone burdens may be cystoscopically managed.
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Affiliation(s)
| | | | - Shujane Shen
- Cleveland Clinic Glickman Urological and Kidney Institute , Cleveland, Ohio
| | - Manoj Monga
- Cleveland Clinic Glickman Urological and Kidney Institute , Cleveland, Ohio
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9
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Tangpaitoon T, Marien T, Kadihasanoglu M, Miller NL. Does Cystolitholapaxy at the Time of Holmium Laser Enucleation of the Prostate Affect Outcomes? Urology 2017; 99:192-196. [DOI: 10.1016/j.urology.2016.08.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 08/26/2016] [Accepted: 08/30/2016] [Indexed: 10/21/2022]
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10
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Yoshida T, Kinoshita H, Nakamoto T, Yanishi M, Sugi M, Murota T, Matsuda T. Conservative Treatment for Benign Prostatic Hyperplasia in Patients With Bladder Stones. Urology 2015; 86:450-3. [PMID: 26235850 DOI: 10.1016/j.urology.2015.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 04/16/2015] [Accepted: 04/21/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine whether conservative management of benign prostatic hyperplasia (BPH) is an appropriate option for patients with bladder stones. METHODS The study cohort comprised 34 men who underwent endoscopic bladder stone removal with subsequent conservative management of BPH, including watchful waiting and medical therapy (alpha-blocker ± dutasteride), between April 2006 and January 2014. We recorded BPH-related complications after stone removal and compared International Prostate Symptom Scores, quality of life scores, and postvoid residual urine volume before and after treatment. Cumulative BPH-related complication-free survival and the preoperative parameters associated with the occurrence of BPH-related complications were also analyzed. RESULTS Twenty-six patients (76.5%) treated with conservative management had no BPH-related complications, during a mean follow-up of 52.6 ± 30.9 months. Mean International Prostate Symptom Scores fell from 13.5 ± 7.1 before treatment to 9.7 ± 6.3 after treatment (P = .025). One of the 34 patients (2.9%) experienced recurrent urinary infections, 2 (5.9%) had urinary retention, and 6 (17.6%) developed recurrent bladder stones. The cumulative BPH-related complication-free survival was 97.0% at 1 year, 81.8% at 3 years, and 70.5% at 5 years. Six of the men (17.6%) underwent invasive intervention for BPH after occurrence of these complications. Prostate volume was the only preoperative parameter associated with the occurrence of complications after stone removal (P = .035). CONCLUSION Conservative management of BPH can be an appropriate treatment option in men with bladder stones and concurrent mild-to-moderate lower urinary tract symptoms.
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Affiliation(s)
- Takashi Yoshida
- Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan
| | - Hidefumi Kinoshita
- Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan.
| | - Takahiro Nakamoto
- Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan
| | - Masaaki Yanishi
- Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan
| | - Motohiko Sugi
- Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan
| | - Takashi Murota
- Department of Urology and Andrology, Kansai Medical University, Takii Hospital, Moriguchi, Japan
| | - Tadashi Matsuda
- Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan
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Minter J, Chiovaro J. Renal failure with a large bladder calculus related to a foreign body: a case report. Clin Case Rep 2014; 2:48-50. [PMID: 25356243 PMCID: PMC4184629 DOI: 10.1002/ccr3.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 01/08/2014] [Accepted: 01/25/2014] [Indexed: 11/06/2022] Open
Abstract
Key Clinical Message We encountered a patient with renal failure in the setting of long-standing difficulty urinating, which he previously treated with intermittent self-catheterizations. Imaging showed a large urinary calculus in the bladder. This case illustrates the importance of taking a detailed history and the dramatic long-term effects of bladder calculi.
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Affiliation(s)
| | - Joseph Chiovaro
- Oregon Health & Science University Portland Oregon
- Portland Veterans Affairs Medical Center Portland Oregon
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13
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Zhao J, Shi L, Gao Z, Liu Q, Wang K, Zhang P. Minimally invasive surgery for patients with bulky bladder stones and large benign prostatic hyperplasia simultaneously: a novel design. Urol Int 2013; 91:31-7. [PMID: 23751405 DOI: 10.1159/000350235] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 02/21/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the efficacy and safety of a novel minimally invasive design for treating bulky vesical calculi and large benign prostatic hyperplasia (BPH) simultaneously. METHODS 76 patients with large bladder stones (>4 cm) and large BPH (≥50 cm³) were treated from August 2008 to January 2011. 38 patients (group 1) underwent transurethral cystolithotripsy followed by transurethral resection of the prostate (TURP), 38 patients (group 2) received percutaneous cystolithotripsy within a laparoscopic entrapment bag and TURP by two surgeons simultaneously. 72 patients were followed up for 1 year. Patient demographics, perioperative parameters and follow-up data were compared. RESULTS Patient baseline characteristics were comparable in the two groups. In group 1, 3 patients converted to open surgery and received blood transfusion, 4 patients had postoperative fever, 2 had residual stones and 1 developed urethral stricture postoperatively. In group 2, the mean total operative and the operative times for stone management were 71.6 and 30.1 min, respectively, the mean hemoglobin decrease was 0.80 g/dl, no patients received blood transfusion and no complications occurred, significantly superior to group 1. CONCLUSIONS Percutaneous cystolithotripsy using a laparoscopic entrapment bag associated with TURP by two surgeons simultaneously is a highly effective, safe and minimally invasive method for managing large vesical calculi and large BPH.
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Affiliation(s)
- Junjie Zhao
- Department of Urology, Yantai Yuhuangding Hospital, Yantai, PR China
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Zhang X, Yu J, Yang R. Minimally invasive management with holmium laser in total urinary tract calculi. Photomed Laser Surg 2013; 31:230-5. [PMID: 23600377 DOI: 10.1089/pho.2012.3455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this article was to study the management of total urinary tract calculi using holmium laser minimally invasive techniques. BACKGROUND DATA It is rare for patients to present kidney stones, ureteral stones, and bladder stones simultaneously, and their treatment is considered to be complicated and difficult, specifically by minimally invasive techniques. METHODS We collected seven cases of total urinary tract calculi from May 2007 to September 2012. Three cases were unilateral, and the others were bilateral. All of the cases presented calculus in the bladder, ureter, and kidney, which were secondary to the long-term indwelling double J stent or lower urinary obstruction. RESULTS Extracorporeal shock-wave lithotripsy (SWL) was administered first, followed by the operation. For patients with bilateral calculi, at one stage, ureteroscopic lithotripsy (URL) with holmium laser was performed in all four cases to remove the bladder and bilateral ureter stones. Then, all patients underwent percutaneous nephrolithotomy (PCNL) with holmium procedures to address the bilateral kidney and upper ureter stones at the second stage. The indwelling double J stents were removed at the same time. For the patients with unilateral calculi, we performed a single operation, but it was conducted using the same treatment sequence as the bilateral procedure. The related symptoms in all cases disappeared after the operation. Re-examination showed that the stones were nearly dissolved and that renal function was recovered. CONCLUSIONS URL with holmium laser for the bladder and ureters combined with PCNL to dissolve kidney and upper ureteral stones could be the ideal choice for the treatment of total urinary tract calculi.
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Affiliation(s)
- Xiao Zhang
- Department of Urology, the Affiliated Hospital of Shanghai JiaoTong University, Shanghai Sixth People's Hospital, Shanghai, China
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El-Halwagy S, Osman Y, Sheir KZ. Shock Wave Lithotripsy of Vesical Stones in Patients With Infravesical Obstruction: An Underused Noninvasive Approach. Urology 2013; 81:508-10. [DOI: 10.1016/j.urology.2012.11.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 10/13/2012] [Accepted: 11/16/2012] [Indexed: 10/27/2022]
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16
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Kingo PS, Ryhammer AM, Fuglsig S. Clinical experience with the Swiss lithoclast master in treatment of bladder calculi. J Endourol 2013; 28:1178-82. [PMID: 23384337 DOI: 10.1089/end.2011.0512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND PURPOSE Bladder calculi account for 5% of urinary tract calculi in the Western world, and many different treatment modalities have been presented throughout the decades. We report our clinical experience using the Swiss LithoClast® Master (SLM). MATERIALS AND METHODS The SLM is a rigid, hand-held endourologic probe including a pneumatic lithotriptor and an ultrasonic lithotriptor. Attached to the ultrasonic modality is a suction system. The two lithotriptor modalities are controlled by a footswitch and can be activated separately or simultaneously. The SLM is used via a rigid endoscope. Indications for treatment were medical complaints such as hematuria, lower urinary tract symptoms, pain, recurrent urinary tract infections, recurrent bursts of balloon in indwelling catheters, and difficulties performing clean intermittent self-catheterization. RESULTS From August 1, 2009, to August 1, 2011, 27 patients were treated for bladder calculi (24 men). Five had a neurogenic voiding dysfunction, 3 had prostate cancer, and 19 had benign prostatic enlargement or detrusor muscle insufficiency. Median age was 74 years (range 45-86 years). Stone clearance was obtained in 26 (96%) patients. Stone burden was one or multiple bladder calculi. Median stone size of the largest stone in each patient was 20 (5-40) mm. Under the same anesthesia, two patients underwent a transurethral resection of the prostate because of a very large prostate. Median lithotripsy time was 60 (range 20-144) minutes. All patients were discharged within 24 hours. CONCLUSION The method described is a safe and quick method for endoscopic lithotripsy of bladder calculi rendering the patients stone free in the vast majority of cases. The procedure can be performed as day-case surgery.
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Affiliation(s)
- Pernille S Kingo
- Department of Urology, University Hospital of Aarhus , Skejby, Aarhus, Denmark
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de la Torre G, Barusso G, Chernobilsky V, Borghi M, Montes de Oca L, Becher E. Outpatient Simultaneous Treatment of Benign Prostatic Hyperplasia and Bladder Lithiasis with GreenLight™ and Holmium Laser. J Endourol 2012; 26:164-7. [DOI: 10.1089/end.2011.0249] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Gabriel Barusso
- Department of Urology, Centro de Urología-CDU, Buenos Aires, Argentina
| | | | - Marcelo Borghi
- Department of Urology, Centro de Urología-CDU, Buenos Aires, Argentina
| | | | - Edgardo Becher
- Department of Urology, Centro de Urología-CDU, Buenos Aires, Argentina
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Na Y, Ye Z, Zhang S. Efficacy and Safety of Dutasteride in Chinese Adults with Symptomatic Benign Prostatic Hyperplasia. Clin Drug Investig 2012; 32:29-39. [DOI: 10.2165/11593750-000000000-00000] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Philippou P, Moraitis K, Masood J, Junaid I, Buchholz N. The management of bladder lithiasis in the modern era of endourology. Urology 2011; 79:980-6. [PMID: 22119259 DOI: 10.1016/j.urology.2011.09.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 09/03/2011] [Accepted: 09/11/2011] [Indexed: 11/30/2022]
Abstract
The recent evolution in the management of vesical lithiasis is a result of the major advancements of modern endourology. The ideal method for achieving stone clearance, however, remains an issue of debate and evidence-based recommendations are lacking. Contemporary literature focuses on management options, such as extracorporeal shockwave lithotripsy, transurethral, percutaneous and minimally-invasive surgery, as well as state-of-the-art energy sources. Issues of particular interest include the results of comparative studies, the management of lithiasis in the paediatric population and the recent challenge of the traditional dogma that dictated BPH surgery for the management of vesical lithiasis secondary to bladder outlet obstruction.
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Affiliation(s)
- Prodromos Philippou
- Endourology & Stone Services, Barts and The London NHS Trust, West Smithfield, London, UK
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Homma Y, Gotoh M, Yokoyama O, Masumori N, Kawauchi A, Yamanishi T, Ishizuka O, Seki N, Kamoto T, Nagai A, Ozono S. JUA clinical guidelines for benign prostatic hyperplasia. Int J Urol 2011. [DOI: 10.1111/j.1442-2042.2011.02861.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Philippou P, Volanis D, Kariotis I, Serafetinidis E, Delakas D. Prospective Comparative Study of Endoscopic Management of Bladder Lithiasis: Is Prostate Surgery a Necessary Adjunct? Urology 2011; 78:43-7. [PMID: 21296391 DOI: 10.1016/j.urology.2010.10.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 10/16/2010] [Accepted: 10/16/2010] [Indexed: 10/18/2022]
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Kara C, Resorlu B, Cicekbilek I, Unsal A. Transurethral Cystolithotripsy With Holmium Laser Under Local Anesthesia in Selected Patients. Urology 2009; 74:1000-3. [PMID: 19773033 DOI: 10.1016/j.urology.2009.05.095] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 04/21/2009] [Accepted: 05/20/2009] [Indexed: 11/16/2022]
Affiliation(s)
- Cengiz Kara
- Department of Urology, Ministry of Health, Kecioren Training and Research Hospital, Kecioren, Ankara, Turkey.
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Marszalek M, Ponholzer A, Pusman M, Berger I, Madersbacher S. Transurethral Resection of the Prostate. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.eursup.2009.02.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Evaluation of percutaneous suprapubic cystolithotripsy under local anesthesia. AFRICAN JOURNAL OF UROLOGY 2009. [DOI: 10.1007/s12301-009-0003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Phosphodiesterase 5 inhibitors in the management of benign prostatic hyperplasia and erectile dysfunction: the best of both worlds. Curr Opin Urol 2009; 19:7-12. [DOI: 10.1097/mou.0b013e328316c357] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shah HN, Hegde SS, Shah JN, Mahajan AP, Bansal MB. Simultaneous transurethral cystolithotripsy with holmium laser enucleation of the prostate: a prospective feasibility study and review of literature. BJU Int 2006; 99:595-600. [PMID: 17026589 DOI: 10.1111/j.1464-410x.2006.06570.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report experience with holmium laser enucleation of the prostate (HoLEP) simultaneously with transurethral holmium laser cystolithotripsy (HLC) for managing bladder outlet obstruction (BOO) and associated vesical calculi; we also review previously reported cases of managing vesical calculi and associated BOO. PATIENTS AND METHODS The high-powered holmium laser is a very efficient multifunctional endourological instrument that effectively fragments calculi of all compositions and is capable of haemostatic cutting of tissue, resulting in minimal bleeding after prostatic resection. A prospective study was conducted from April 2003 that included 32 men who underwent simultaneous HoLEP with transurethral HLC at our institution. Demographic, laboratory, peri-operative and follow-up data were analysed. Complications during and after surgery were identified to assess the morbidity of procedure. RESULTS The mean (range) size of bladder calculi was 34.6 (12-70) mm and the preoperative weight of the prostate was 51.9 (11-172) g. Combined HoLEP with transurethral HLC was technically feasible in all patients, and all were stone-free after surgery. The mean operative duration was 97.7 (40-230) min, the weight of prostate tissue removed 34.6 (5-88) g, and the duration of catheterization and hospital stay 29.3 h and 34.8 h, respectively. Complications during and after surgery occurred in 12.5% and 15.6% of patients, respectively; all complication were minor and none caused any residual disability to the patient. No patient required a blood transfusion or developed clot retention. CONCLUSIONS Managing bladder stones and BOO with simultaneous transurethral HLC and HoLEP should be considered the treatment of choice for such cases. Stones of any size and composition, and prostates of practically any size can be treated endoscopically using the holmium laser, with acceptable morbidity once the technique is mastered. The review of previous reports suggested a need for a prospective study comparing endoscopic management of BOO and associated bladder stones, with medical management of BOO and extracorporeal shock wave lithotripsy/endoscopic lithotripsy for bladder stone.
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Affiliation(s)
- Hemendra N Shah
- Department of Urology, R.G. Stone Urological Research Institute, Mumbai, Maharashtra, India.
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Tzortzis V, Aravantinos E, Karatzas A, Mitsogiannis IC, Moutzouris G, Melekos MD. Percutaneous suprapubic cystolithotripsy under local anesthesia. Urology 2006; 68:38-41. [PMID: 16806418 DOI: 10.1016/j.urology.2006.01.073] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2005] [Revised: 12/19/2005] [Accepted: 01/30/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To assessed the feasibility and effectiveness of percutaneous cystolithotripsy under local anesthesia in selected patients. METHODS Thirty-one patients with bladder stones of different etiologies underwent percutaneous cystolithotripsy under local anesthesia. Suprapubic access was obtained with ultrasound guidance, and fragmentation of the stone was performed using the Swiss lithoclast. Suprapubic and transurethral catheters were placed postoperatively. RESULTS No major intraoperative complications occurred. The whole procedure was well tolerated, and no significant differences were found in the mean pain score between the percutaneous suprapubic cystolithotripsy group and a group of male patients who underwent rigid cystoscopy under local anesthesia (P = 0.35). Complete stone clearance was achieved in all but 1 patient (96.78%). Bladder irrigation because of gross hematuria was needed in 5 patients, but no blood transfusion was required. Fever developed in 1 patient and was treated with intravenous antibiotics. The average hospitalization was 2.3 days (range 2 to 5). After a mean follow-up of 10 months, no recurrent stone developed. CONCLUSIONS Percutaneous suprapubic cystolithotripsy under local anesthesia is a safe and effective technique to remove bladder calculi. Thus, it may be used as an alternative treatment option in selected patients.
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Affiliation(s)
- Vassilios Tzortzis
- Department of Urology, University of Thessaly School of Medicine, Larissa, Greece.
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Sofer M, Kaver I, Greenstein A, Bar Yosef Y, Mabjeesh NJ, Chen J, Ben-Chaim J, Matzkin H. Refinements in treatment of large bladder calculi: simultaneous percutaneous suprapubic and transurethral cystolithotripsy. Urology 2005; 64:651-4. [PMID: 15491692 DOI: 10.1016/j.urology.2004.04.067] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2004] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To present a combined endourologic approach to treat bladder calculi consisting of simultaneous percutaneous suprapubic and transurethral cystolithotripsy. METHODS We report on a series of 12 consecutive patients with bladder stone burdens of 40 mm or greater. Percutaneous 30F access was obtained under cystoscopic control. Fragmentation and stone removal were performed simultaneously by two urologists using a Swiss lithoclast, holmium laser, and/or ultrasound lithotriptor through both percutaneous and transurethral routes. Suprapubic and transurethral catheters were placed postoperatively. RESULTS Twelve patients with a median age of 66 years (range 33 to 80) were treated by simultaneous percutaneous suprapubic and transurethral cystolithotripsy. Six underwent transurethral resection of the prostate at the completion of stone clearance. The median stone size was 60 mm (range 40 to 80), and the median lithotripsy time was 56 minutes (range 45 to 70). The median postoperative hospitalization was 2.7 days (range 2 to 5), and complete stone clearance was achieved in all cases. One patient, who underwent concomitant transurethral resection of the prostate, developed urinary retention 1 week postoperatively and was successfully treated by temporary transurethral catheterization. One patient with a positive urine culture preoperatively developed fever on the first postoperative day and was treated with intravenous antibiotics according to the antibiogram results for 5 days. No other complications had occurred after a median follow-up of 10 months (range 3 to 15). CONCLUSIONS Simultaneous percutaneous suprapubic and transurethral cystolithotripsy appears to be a safe approach for the management of large bladder calculi and may shorten the total fragmentation time. It can be combined with transurethral resection of the prostate without prolonging hospitalization. The simultaneous use of two modalities of stone fragmentation represents an effective and minimally invasive way of treating large bladder calculi.
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Affiliation(s)
- Mario Sofer
- Department of Urology, Tel-Aviv Sourasky Medical Center, Tel-Aviv University Sackler Faculty of Medicine, Israel
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AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol 2003; 170:530-47. [PMID: 12853821 DOI: 10.1097/01.ju.0000078083.38675.79] [Citation(s) in RCA: 747] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
PURPOSE OF REVIEW Despite modern antibiotic therapy and technological advances in lithotripsy, the presence of infection in urinary stone patients as well as infectious stones are still a significant cause of morbidity and mortality. Many new investigations are focusing on the pathogenesis and treatment of these difficult cases. RECENT FINDINGS Most of the current literature on the subject focuses on pathogenesis of infectious urinary stones. The remaining literature highlights difficult cases, outcomes of treatments, and overall reviews of the subject. SUMMARY Recent findings lend more theories as to how infection leads to stone formation. Further investigation is critically needed to improve the outcomes of patients suffering from infections with urinary stones and infectious stones.
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Affiliation(s)
- Harrison M Abrahams
- Department of Urology, University of California San Francisco, 400 Parnassus Avenue, San Francisco, CA 94143, USA
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