Transurethral cystolithotripsy with holmium laser under local anesthesia in selected patients.

Abstract

OBJECTIVES:

To evaluate the feasibility and effectiveness of transurethral holmium:yttrium-aluminum-garnet (YAG) laser cystolithotripsy under local anesthesia in selected patients.

METHODS:

Thirteen consecutive male patients with large bladder calculi (3 cm or greater) caused by benign prostatic hyperplasia underwent transurethral cystolithotripsy using holmium:YAG laser under local anesthesia. The operation was performed with all the patients in the lithotomy position (except 3 with pelvic prosthesis). All patients underwent transurethral holmium laser cystolithotripsy (HLC) with a flexible cystoscope under local anesthesia by 1 surgeon. A urethral Foley catheter was placed postoperatively.

RESULTS:

Thirteen patients with a mean age of 58.2 years were managed with HLC. All patients were rendered stone-free, regardless of stone size. No patient underwent transurethral resection of the prostate at the completion of the procedure. The mean stone size was 3.6 cm (range 3-5) and the mean operative time was 51 minutes (range 45-65). The whole procedure was well tolerated and no significant differences were found in the mean pain score between the HLC group and a group of male patients who underwent flexible cystoscopy under local anesthesia (2.15 vs 1.86, respectively; P = .467). No major intraoperative complication occurred. The mean hospitalization was 2.3 days. After a mean follow-up of 16.6 months, no recurrent stone, urinary retention, or urethral stricture developed.

CONCLUSIONS:

Transurethral holmium:YAG laser lithotripsy under local anesthesia appears to be a safe and effective technique for the large bladder calculi. Thus, it may be used as an alternative treatment option in selected patients.

• Authors: Cengiz Kara, Berkan Resorlu, Izzet Cicekbilek, Ali Unsal
• Journal: Urology (Urology) Vol. 74 Issue 5 Pg. 1000-3 (Nov 2009) ISSN: 1527-9995 [Electronic] United States
• PMID: 19773033 (Publication Type: Journal Article)

Topics

• Aged
• Anesthesia, Local
• Feasibility Studies
• Humans
• Lasers, Solid-State
• Lithotripsy, Laser (methods)
• Male
• Middle Aged
• Prospective Studies
• Urethra
• Urinary Bladder Calculi (therapy)