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Percutaneous intervention of large bladder calculi in neuropathic voiding dysfunction
1Division of Urology, University of Florida College of Medicine, Jacksonville, Florida 32209, USA.
Summary
Percutaneous cystolitholapaxy is a safe and effective minimally invasive option for large bladder stones in patients with neuropathic voiding dysfunction (NVD). This approach offers a preferred solution for stone removal in this challenging patient group.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Nephrology
Background:
- Neuropathic voiding dysfunction (NVD) often complicates bladder stone management.
- Large bladder calculi present unique challenges in patients with NVD.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous cystolitholapaxy for large bladder calculi in patients with NVD.
- To present the rationale and outcomes of this minimally invasive approach.
Main Methods:
- Retrospective review of ten patients with NVD and large bladder calculi.
- Analysis of percutaneous cystolitholapaxy and transurethral stone removal procedures.
- Comparison of operative times and blood loss between the two methods.
Main Results:
- Percutaneous cystolitholapaxy for large stones (up to 8x7 cm) had a mean surgery length of 150 min and blood loss of 23 mL.
- Transurethral removal for smaller stones (up to 4x4 cm) had a mean surgery length of 111 min and blood loss of 8 mL.
- No statistically significant difference in operative time or blood loss between the two techniques.
Conclusions:
- Percutaneous cystolitholapaxy is a safe, effective, and often preferred minimally invasive option for large bladder calculi in NVD patients.
- Guidelines for endoscopic management in this population are suggested.
- Larger, prospective studies are needed for definitive conclusions.
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