Cystolithotripsy (Laser)

Overview

As opposed to an open surgery, laser Cystolithotripsy is a minimally invasive procedure used for the crushing and removal of bladder stones. It is safe and effective for treating large bladder stones without injuring the urethral or causing excessive blood loss. When bladder stones turn hard and large, laser rays help to fragment and remove them easily.

The concept of Cystolithotripsy has undergone a remarkable evolution in the past one decade with the introduction of holmium laser. Stones that were removed by open surgeries earlier got replaced with newer technologies and minimally invasive procedures. Due to this, it became easier to remove stubborn stones without causing any pain and ensuring quicker recovery.

Indications of bladder stones are in the form of blood in the urine, lower abdominal pain, pain and discomfort in the testicles and penis (only in men), frequent urination, difficulty in urinating, cloudy urine, chronic bladder infections and incomplete bladder emptying. As the situation worsens, urinary minerals and sediment collect to form bladder calculi.

Causes of bladder stones are linked to prostate gland enlargement, neurogenic bladder (damaged nerves), bladder inflammation, small kidney stones that may travel to the bladder and medical devices (bladder catheters, stents) if accidentally left inside. Certain tests and diagnosis determine if you have stones in the bladder. A thorough physical examination is likely to evaluate the size of your bladder and prostate since an enlarged size indicates bladder stones. Analysis of urine helps determine infections in the urinary tract caused by stones in the bladder.

Doctors prefer ultrasound technique to detect bladder stones by transmitting sound waves that bounces back after hitting the structures and organs of the body to create pictures. Other than this, X-rays and computerized tomography are effective for fnding small stones in the bladder.

If left untreated, bladder stones can result into complications. Although, doctors often recommend drinking a lot of water to help stones pass through urine, this is not an ideal technique since the condition may cause inability to urinate smoothly. Using laser Cystolithotripsy helps to remove any stone with maximum precision. You need some preparations before a laser Cystolithotripsy procedure.

Before the Treatment

• Upon noticing any signs and symptoms of bladder stones, see a doctor right away.
• Let him know if you have any major stresses or tensions in life or about any recent life changes. Also, tell him about the medications (vitamins and supplements) you are taking.
• After diagnosis, if the doctor wants to perform a Cystolithotripsy procedure, ask him about the details of the surgery, side effects and results.
• Avoid medications as advised by your doctor for at least 7-10 days before the surgery. Aspirins ad blood thinners are particularly not allowed since they may interfere with the surgery and your recovery.
• There is no bowel preparation required for the procedure.

How it is performed

• After evaluating the sizes and shapes of the stone from your test results, surgeons prepare you for the procedure. You are transferred to the operating table and administered general and spinal anaesthesia.
• A small cystoscope that has a camera and light attached to one end is inserted through the urethra into the urinary bladder.
• A basket device is used to pluck and trap stones from the inner walls of the bladder, which are then removed. However, larger stones that cannot be removed with the basket are fragmented with laser rays emitted from an instrument put inside the cystoscope. The small pieces are then removed from the bladder.

Recovery

An overnight stay at the hospital is required after the procedure. You are discharged on the next day with a prescription of oral antibiotics that should be taken for the next 4-5 days. The total recovery of Cystolithotripsy generally takes a week or more.

Adequate care should be taken after the surgery to ensure quicker recovery. Include salt in your diet to increase the quantity of calcium in your urine, and decrease sodium intake as much as possible. In addition, take more fibre-rich foods like wheat, legumes, rice bran that protect against kidney stones.