International Journal of Contemporary Surgery
  • Year: 2015
  • Volume: 3
  • Issue: 2

A Study of Management of Urinary Bladder Stone by Cystoscopic Transurethral Pneumatic Cystolithotripsy in Rural India

1Associate Professor, Department of General Surgery, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh, India

2Associate Professor, Department of Obstetrics and Gynaecology, Rama Medical College Hospital & Research Centre, Hapur, Uttar Pradesh, India

Online published on 13 July, 2015.

Abstract

Bladder stones develop when urine becomes concentrated in the bladder, causing crystallization of minerals in the urine. Urinary stones may develop due to some type of infection. These infections produce an enzyme called urease, which causes the urine pH to increase, favouring the formation of magnesium ammonium phosphate (struvite) crystals. Recently it has been observed that the urinary stones are increasing specially in low socioeconomic group.1

Treatment of bladder stone is surgery. Traditionally surgery for bladder stone is done by the open cystolithotomy. Which gives long scar, causes increase in morbidity, long hospital stay and increase in cost. Some time there may be wound infection. With the invent of new endoscopic modalities all these can be prevented. Patient can go home very next day of stone removal.

Patients were diagnosed with bladder stone by ultasonography and x-ray KUB were admitted for cystoscopic transurethral pneumatic lithotripsy in the department of surgery, Saraswathi institute of Medical Sciences between 2008 and Feb 2015. Pneumatic lithotripter was used through 22 Fr cystoscope to fragment the stone in 50 patients.

In all the patients complete evacuation of fragmented stones was done with the help of Ellik's evacuator. Very few patients had per operative complication like haematuria, which was minute. Few had post operative complication like retention of urine. These complications were taken care of. Overall results were good. Patients were returned to normal work after 24 hrs. Procedure was cost effective to the patient.

This method transurethral cystoscopic pneumatic lithotripsy helps in removing urinary bladder stone. There is no scar, morbidity is reduced and cost effective since 5 to 10 litter of normal saline and a folly's catheter is used during the surgery. Over all the equipments costs about 2lac of rupies. Which is one time investment. No much expertise is needed for the procedure.

Keywords

Cystoscopic transurethral pneumatic cystolithotripsy, vesical calculus