Laser Resectoscope versus Cystoscope in Transurethral Management of Bladder Stones: A Comparative Study

The aim of this study was to compare the clinical outcomes of cystoscopy and laser resectoscope used during transurethral cystolithotripsy (TUC) and to evaluate the efficacy and reliability of these two endoscopic instruments.

This study included patients who underwent transurethral bladder stone (BS) surgery between 2022 and 2025. Patients were categorized into cystoscope and laser resectoscope groups according to the endoscopic instrument used. Lithotripsy was performed using a holmium laser in all cases. Demographic characteristics, stone-related parameters, perioperative variables, and clinical outcomes were analyzed comparatively. Statistical analyses were performed using appropriate tests, and a p value <0.05 was considered statistically significant.

A total of 80 patients were included (Group 1: cystoscope, n = 40; Group 2: laser resectoscope, n = 40). No significant differences were found between groups regarding age, body mass index, number of stones, or stone size (p > 0.05). Operation and lithotripsy times were significantly shorter in the laser resectoscope group (29 vs. 45 min; 18 vs. 23 min, respectively; p < 0.001). Stone visualization quality was higher in this group, and mucosal bleeding was significantly less frequent (p = 0.014). No significant differences were observed regarding hospital stay, catheterization duration, or overall complication rates.

Comparable stone-free and safety outcomes were achieved with TUC performed using either a cystoscope or a laser resectoscope. However, the laser resectoscope provided shorter operative times, improved visualization, and reduced mucosal injury, indicating that it is an effective and reliable alternative for TUC.