Cystolitholapaxy means to break / treat the stones that are in the urinary bladder.
Bladder outflow obstruction (BOO) caused by benign prostatic hyperplasia (BPH) is the commonest cause of bladder stones in the developed world. In addition, approximately 2% of patients having surgery for BPH are found to have bladder stones (1). According to EAU and AUA Guidelines, the presence of bladder stones is a strong indication for surgical treatment of BOO.
There are many techniques for treating bladder stones and variations as we could decide to treat the prostate at the same operation or not. Usually we advise not to treat the prostate only if the patient’s condition does not allow it, otherwise we advise to deal with that at the same operation if possible.
The most favourite options are:
- Percutaneous suprapubic cystolithotomy / medical management of BPH
- TransUrethral Cystolithotripsy and conservative / medical treatment of BPH
- Extracorporeal Shock Wave Lithotripsy + TURP at a 2nd time
- Open cystolithotomy and transvesical simoultaneous adenomectomy
- Transurethral cystolithotripsy and transurethral prostatectomy at a 2nd time
- Holmium Enucleation of the Prostate (HoLEP™) and cystolitholapaxy
- GreenLight™ Photoselective Vaporization of the Prostate (PVP) and cystolitholapaxy
The last two options are those more minimally invasive and at the same time can fix everything in a single-step-operation, they are recommended by the author.