Is Cystolitholapaxy Sufficient in Patients With Bladder Stones Secondary to Benign Prostatic Obstruction?

Area of Science:

• Urology
• Surgical Innovation
• Patient Outcomes

Background:

• Benign prostatic obstruction (BPO) can lead to bladder stones (BS).
• The necessity of simultaneous BPO intervention with cystolitholapaxy for BS is questioned.
• Predictors for secondary intervention require investigation.

Purpose of the Study:

• To evaluate the need for concurrent BPO surgery during cystolitholapaxy for BS.
• To identify factors predicting the requirement for secondary interventions post-cystolitholapaxy.

Main Methods:

• A cohort of 235 male patients over 40 with BS secondary to BPO underwent cystolitholapaxy.
• Follow-up exceeded 12 months.
• Patients were categorized based on the need for secondary intervention.

Main Results:

• 19.5% of patients required secondary intervention after a mean follow-up of 49 months.
• Lower peak urine flow rate (Qmax), higher postvoid residual volume (PVR), higher International Prostate Symptoms Score (IPSS), and higher prostate-specific antigen (PSA) were associated with secondary intervention.
• Multivariable analysis confirmed low Qmax, high PVR, high IPSS, and high PSA as significant predictors.

Conclusions:

• Cystolitholapaxy alone is often sufficient, minimizing the need for additional procedures.
• Preoperative identification of low Qmax, high PVR, high IPSS, and high PSA can guide decisions on concurrent BPO surgery.
• A patient-centered approach incorporating these predictors optimizes treatment planning.