[Endoscopic cystolithotomy: hypogastric approach]

Vesical lithiasis is a relatively frequent problem, the solution of which has changed over the last few years driven by major technological evolution. Traditional open surgery has been outstaged by the new endoscopic techniques and extracorporeal lithotrity. Here, we present our endoscopic resolution protocol through a hypogastric puncture approach, using a conventional nephroscope, with or without the use of ultrasound. This technique has been applied to 39 patients obtaining a 97.4% success rate with minimal morbidity. This procedure is usually performed under local anaesthesia and ambulatory, using an urethrovesical catheter for 1 to 2 days. This approach offers certain advantages over the one through the urethra due to the difficulties of passage through the latter, and the inconvenience of working within a relatively narrow and rigid duct. It is faster and more efficient than extracorporeal lithotrity especially in the presence of very hard or very numerous calculi and, if necessary, can be complemented immediately with a prostate transurethral resection. In summary, this is a simple, efficient and safe technique, and it has become our choice therapy to resolve a vesical lithiatic condition in males.