Simple Solution to a Difficult Problem: Removal of Large Bladder Calculi Using a Laparoscopic Entrapment Sac
Gregory R Mullen1, William Atallah1, Kasmira R Gupta1
1Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA.
Journal of Endourology
|September 29, 2020
Summary
Modified percutaneous entrapment sac cystolithotomy (mPESC) offers a simpler, safer approach for managing large bladder calculi. This minimally invasive technique reduces complications and hospital stay compared to the original procedure.
Area of Science:
- Urology
- Minimally Invasive Surgery
Background:
- Percutaneous management of large bladder calculi traditionally involves open cystolithotomy or transurethral cystolithotripsy.
- Standard percutaneous cystolithotomy has limitations, prompting the development of minimally invasive alternatives.
Purpose of the Study:
- To assess the continued feasibility of percutaneous entrapment sac cystolithotomy (PESC).
- To describe modifications simplifying the technique (mPESC).
- To compare outcomes and complications between PESC and mPESC.
Main Methods:
- Forty-seven male patients underwent either PESC (16 patients) or mPESC (31 patients) between 2008 and 2019.
- Post-procedure, either a suprapubic (SP) catheter or a urethral catheter was used.
- Operative and follow-up parameters were compared between the two groups.
Main Results:
- All patients achieved stone-free status.
- The mPESC group demonstrated significantly shorter procedure times and hospital stays.
- The original PESC group experienced higher rates of SP site leakage, prolonged catheterization, and recurrent retention.
Conclusions:
- Modifications to PESC (mPESC) result in fewer complications and reduced length of stay.
- mPESC is a safe, efficacious, and well-suited outpatient procedure for managing large bladder calculi.
- This technique effectively reduces morbidity associated with bladder stone treatment.
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