Bladder lithiasis: from open surgery to lithotripsy

Area of Science:

• Urology
• Nephrology

Background:

• Bladder calculi represent 5% of all urinary calculi.
• Risk factors include bladder outlet obstruction, neurogenic voiding dysfunction, infection, foreign bodies, and specific surgeries in males and females.

Purpose of the Study:

• To review the current treatment modalities for bladder calculi.
• To highlight emerging and established surgical and non-surgical interventions.

Main Methods:

• Review of established and novel treatments for bladder calculi.
• Discussion of open surgery, endoscopic procedures (mechanical, ultrasound, electrohydraulic, laser), and extracorporeal shock wave lithotripsy.
• Mention of recent percutaneous and combined endoscopic-percutaneous approaches.

Main Results:

• Open surgery is primary for pediatric bladder calculi.
• Adult treatment classically involves endoscopic transurethral disintegration using various lithotripsy methods.
• Extracorporeal shock wave lithotripsy is effective and well-tolerated, especially in high-risk patients.
• Novel techniques like simultaneous percutaneous and transurethral cystolithotripsy have been explored.

Conclusions:

• Treatment selection depends on patient age, stone size, and patient risk factors.
• Minimally invasive techniques are preferred when feasible.
• Extracorporeal shock wave lithotripsy presents a viable, less invasive option for select populations.