Cystolitholapaxy
What is cystolitholapaxy?
Cystolitholapaxy is a minimally invasive procedure used to remove stones from the bladder. A thin telescope is passed through the urethra into the bladder where the stone is located. The stone is then broken into smaller fragments, which are removed from the bladder. This procedure is commonly performed when bladder stones cause symptoms such as pain, infection or difficulty passing urine. It offers an effective way of clearing stones without the need for external incisions.
Why is it needed?
Cystolitholapaxy may be recommended when a bladder stone is too large to pass naturally or when it is causing troublesome urinary symptoms such as frequency, urgency or discomfort. The procedure may also be advised for individuals who experience repeated urinary tract infections related to a stone.
Bladder stones may form because of underlying conditions such as an enlarged prostate, incomplete bladder emptying or long-term catheter use. Treating the stone can help relieve symptoms and prevent recurrent infections.
What happens during the procedure?
The procedure is usually performed under general or spinal anaesthesia. A cystoscope is inserted through the urethra into the bladder to visualise the stone. The stone is then broken into smaller pieces using laser energy, ultrasonic energy or a mechanical device.
Once fragmented, the pieces are washed out of the bladder or removed using suction. A catheter may be placed temporarily for one to two days to help drain the bladder and support healing. The procedure typically takes between thirty and sixty minutes depending on the size and number of stones. Most people go home the same day or after an overnight stay.
What are the alternatives?
Small bladder stones that do not cause symptoms may be monitored without intervention. Open surgery may be considered for very large stones or multiple stones, although this is rarely required.
In some centres, shock wave therapy may be used for selected stones. Treating underlying issues such as prostate enlargement or catheter-related problems is important to prevent new stones from forming and may be part of the overall management plan.
Potential risks and after effects
Cystolitholapaxy is generally safe and effective, but some temporary effects may occur. Burning or discomfort when passing urine is common for one to two days. Mild blood in the urine may be present initially and usually settles quickly.
A urinary tract infection may occur and may require antibiotics. Rarely, injury or narrowing of the urethra may develop. In some cases, stone fragments may remain and require further treatment. Bladder stones may recur if the underlying causes are not addressed, particularly in individuals with incomplete bladder emptying.
After the procedure
Following the procedure, drinking plenty of fluids helps flush the bladder and reduce irritation. Mild discomfort or small amounts of blood in the urine are common for a short period.
Strenuous activity and heavy lifting should be avoided for approximately one week. Medical advice should be sought if fever, increasing pain or difficulty passing urine develops.
Follow-up care
A follow-up appointment is usually arranged within four to six weeks to assess healing and bladder emptying. Imaging or repeat cystoscopy may be recommended if symptoms persist or if there is concern that fragments remain.
Further treatment may be needed if underlying issues such as prostate enlargement contribute to stone formation. Long-term monitoring and management can help prevent recurrence.
Bladder Procedures
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