How I do it: percutaneous cystolitholapaxy for bladder stones with complex lower urinary tract anatomy

Area of Science:

• Urology
• Minimally Invasive Surgery
• Endourology

Background:

• Transurethral cystolitholapaxy can be challenging for large or complex bladder stones, particularly in patients with altered lower urinary tract anatomy.
• Conditions such as benign prostatic hyperplasia, urethral strictures, or urinary diversions can limit the efficacy of traditional transurethral approaches.

Purpose of the Study:

• To review the indications, advantages, and techniques of percutaneous cystolitholapaxy (PCCL) as an alternative to transurethral methods.
• To describe the procedural steps, equipment, and management strategies for PCCL.
• To present institutional outcomes data highlighting the safety and efficacy of PCCL.

Main Methods:

• Review of indications and advantages of PCCL.
• Step-by-step description of the percutaneous cystolitholapaxy technique.
• Discussion of preoperative/postoperative care, complication management, and outcome optimization.
• Analysis of institutional case series data.

Main Results:

• Percutaneous cystolitholapaxy is a safe, effective, and minimally invasive option for bladder stones in challenging patient populations.
• The procedure is feasible across diverse indications, including benign prostatic hyperplasia and urinary diversions.
• Institutional outcomes demonstrate the procedure's safety and efficacy.

Conclusions:

• Percutaneous cystolitholapaxy provides a valuable alternative for bladder stone management when transurethral approaches are inadequate.
• Careful technique and management optimize outcomes and patient safety.
• This approach expands treatment options for complex bladder stone cases.