Safety and effectiveness of ultrasound-guided suprapubic cystolithotripsy for vesical calculi - A chart review
Journal Title: Medpulse International Journal of Surgery - Year 2019, Vol 9, Issue 2
Abstract
Background: We evaluated safety and effectiveness of a minimally invasive surgical technique involving ultrasound guided supra-pubic percutaneous access with desired size amplatz sheath placement under direct- vision for managing bladder stones for all the age groups including patients who underwent laparotomy and have an abdominal scar. Methods: Thirty-two patients underwent this technique for either having a single stone or multiple bladder stones between 10-30 mm in diameter. All patients were candidates for open surgery. The procedure was under direct cystoscopic vision and introduction of nephroscope into the bladder suprapubically. Stones were fragmented with lithotripter, and stone clearance was assessed using ultrasonogram. Results: There were three females and 29 males. The age of the patients was 45.3±18.3 years. The average size of the stone was 2.9±0.8 cm. The median number of stones were four ranging from 1 to 15. The mean surgery time and hospital stays were 36±13 minutes and 3±1 days respectively. 2/32 (6.25%) patients had already undergone laparotomy and had abdominal scars. All 32/32, (100%) patients had a stone-free bladder. One patient developed a mild urinary leak at the supra pubic catheter site, which subsided within 24 hours. No intra operative or postoperative complications were observed. All patients were discharged on the fifth postoperative day. Conclusion: Percutaneous cystolithotripsy under ultrasound cont rol is safe and comfortable to perform and should be considered in patients with large or multiple bladder stones and post laparotomy abdomen with scars as it decreases the risk of urethral stricture and trocar induced bowel or vascular injuries.
Authors and Affiliations
Sreedhar Dayapule, SuryaKumari Uppalapati, Chadalawada Nageswara Rao, , Sandeep Davalla, Ritvij Patankar, Ramamohan Pathapati
Keywords
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- EP ID EP471872
- DOI 10.26611/1069212
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