Endoscopic Cystolitotomy: Closed Bladder Stone Surgery

Endoscopic cystolithotomy is a modern surgical procedure that enables the removal of bladder stones using a minimally invasive (closed) technique. This method allows urinary tract stones to be cleared safely and quickly without the need for open surgery.

What Is Endoscopic Cystolitotomy (Closed Bladder Stone Surgery)?

Cystolitotomy is a surgical procedure to remove stones from the bladder. Bladder stones usually form due to blockages in the urinary tract, infections, or other causes. These stones can cause difficulty or pain when urinating.

Cystolitotomy surgery is performed to remove these stones from the body. Typically, the stones are accessed and removed through an incision made in the lower abdomen.

After the surgery, the bladder returns to its normal function. This method is particularly preferred for large stones or stones lodged in the urinary tract. Cystolitotomy can be performed using open surgery or endoscopic techniques. The method to be used will be determined according to the size and location of the stone, and the patient's general health condition.

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How Is Endoscopic Cystolitotomy (Closed Bladder Stone Surgery) Performed?

Treatment for bladder stones is determined by the size and number of stones, their cause, and the patient's general health condition. If the stone is smaller than 0.5 centimeters in diameter, it is expected to pass spontaneously, or its expulsion can be facilitated with appropriate supportive treatments.

In laparoscopic bladder stone surgery, the bladder is accessed through a natural pathway via the urethra, and no surgical incision is made. Stones inside the bladder are broken into small pieces using laser, pneumatic, or ultrasonic lithotriptor devices.

Then the stone fragments are removed by a washing system. If necessary, additional problems such as urinary tract strictures or prostate enlargement can also be treated during the same procedure. A catheter is temporarily inserted after the procedure, and usually a one-night hospital stay is sufficient.

Recovery after bladder stone surgery is quick and comfortable. Due to its rapid recovery process and high success rate, laparoscopic bladder stone surgery is one of the frequently preferred treatment methods today.

Is Endoscopic Cystolitotomy Risky?

As with any surgical procedure, there are some risks, although rare. The risks specific to the surgery are listed below:

• Damage to the urinary tract may occur in less than 1% of cases. This can lead to urinary incontinence or stricture.
• A perforation may occur in the bladder wall. Rarely, open surgery may be necessary.
• Temporary inability to urinate (retention) may occur. A short-term catheter (probe) insertion may be necessary.
• A temporary slowdown in bowel movements may occur. It may be accompanied by abdominal bloating or vomiting.
• An increase in urinary incontinence or existing urinary leakage symptoms may be observed.
• Rarely, infections can spread to the bloodstream (sepsis). It requires antibiotic treatment.
• Bleeding may occur in 10-25% of cases. There may be a darkening of the urine color or a blockage in the flow.
• Burning and stinging sensation during urination may last for a few days. It usually resolves when the probe is removed.
• Stone fragments can remain in the bladder and may not pass on their own.
• People who are overweight or smoke have an increased risk of wound infections, lung infections, blood clots, and cardiovascular problems.

How Long Does A Laparoscopic Bladder Surgery Take?

In closed bladder stone surgery (via cystoscopy), bladder stones are removed endoscopically. The procedure is usually completed in 30 minutes to 1 hour.

The duration of the surgery may vary depending on the patient's general health, the size, location, and number of stones. The anesthesia time is also included in the total procedure time.

What Precautions Should Be Taken After Bladder Surgery?

You can take a bath starting from the 7th day after surgery, unless your doctor advises otherwise. There is no harm in water coming into contact with the wound areas or the catheter. However, it is recommended to gently dry the surgical area after bathing.

Since it may take time for bowel movements to return to normal, you should avoid heavy meals and gas-producing drinks for the first 3-4 days after surgery. During this period, light foods such as vegetables, boiled dishes, custard, mashed potatoes, and soup can be preferred. Drinking only water will be sufficient as a liquid.

When making sudden movements, coughing, getting out of bed, or standing up from a sitting position, tighten your anal and gluteal muscles, just as you would during exercise. Keeping these muscles contracted while you move can help prevent urinary incontinence.

The following are important points to consider after bladder surgery:

• Keep the wounds clean and dry.
• Always dry the surgical area thoroughly after showering.
• Avoid heavy lifting.
• Do not use medication without consulting a doctor.
• Move slowly and cautiously.
• Drink plenty of water and avoid constipation.
• Do not miss any of the check-ups your doctor has prescribed.

Which Doctor Performs Closed Bladder Stone Surgery?

Closed bladder stone surgery (endoscopic cystolithotomy) is evaluated by a urologist specializing in urinary system stones and bladder dysfunction.

Frequently Asked Questions About Laparoscopic Bladder Stone Surgery

Below are frequently asked questions and answers about closed bladder stone surgery (endoscopic cystolithotomy).

Is Bleeding Normal After Bladder Stone Surgery?

After endoscopic stone crushing/removal procedures, blood and clots in the urine may persist for a few days.

What Kinds Of Pain Can Be Experienced After Bladder Stone Surgery?

Burning sensation during urination, frequent urge to urinate, and discomfort or pain in the lower abdomen/bladder area are common complaints after the procedure.

How Long Does Recovery Take After Bladder Surgery?

Hospital stay for minor endoscopic procedures is typically 12-36 hours, and it may take several days or weeks to regain full comfort. If major/open surgery was performed, the recovery period may be even longer.