Safety and Efficacy of a Novel Modified Resectoscope for Transurethral Cystolithotripsy Designed to Manage Bladder...

This study aimed to evaluate the safety and efficacy of a novel transurethral cystolithotripsy device designed to manage bladder calculi.

Consecutive patients with bladder calculi who underwent transurethral cystolithotripsy at our medical center performed by the same surgical team between January 2014 and July 2019 were included. Patients' medical records data were evaluated retrospectively. Patients were divided into three groups based on the cystolithotripsy approach used: Conventional transurethral discontinuous flow cystoscope (Group 1); Ureteroscope inserted into a 26 Fr resectoscope sheath (Group 2); And Group 3 received treatment using our redesigned resectoscope incorporating an Fr5 guide catheter replacing the conventional electricity loop (Group 3).

In total, 69 patients were included. Postoperative ultrasonography confirmed complete stone clearance in all groups. The median lithotripsy operation time was significantly shorter in Group 3 (20.00 min, Q1-Q3: 15.00-25.00) compared to Group 1 (40.00 min, Q1-Q3: 40.00-60.00) and Group 2 (27.50 min, Q1-Q3: 15.00-36.25) (p < 0.0001). Group 3 also required the least irrigation fluid (12.00 L, Q1-Q3: 6.00-20.25), compared to Group 1 (33.00 L, Q1-Q3: 27.00-36.00) and Group 2 (39.00 L, Q1-Q3: 29.25-45.75) (p < 0.0001). No vesical perforation occurred in Group 3, while one case occurred in Groups 1 and 2. Postoperative fever was observed in three patients from Group 1 and two from Group 3. No other intraoperative or postoperative complications were noted.

Our redesigned continuous-flow resectoscope is a safe and highly effective modality for treating bladder calculi, reducing operative time and irrigation volume significantly compared to conventional methods, while maintaining a low complication rate. Study findings suggest that this novel approach may serve as a cost-effective and efficient alternative for transurethral cystolithotripsy.