Cystoscopy & litholapaxy (bladder stone crushing/removal)

What is this?

This procedure involves crushing or disintegration of bladder stone(s) using telescopic instruments or laser and removal of the stone fragments using suction apparatus

What alternatives are there?

Open surgery, observation.

What to expect before procedure

You will usually be admitted on the same day as your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

What happens during the procedure?

Either a full general anaesthetic (where you will be asleep throughout the procedure) or a spinal anaesthetic (where you are awake but unable to feel anything from the waist down) will be used. All methods minimise pain; your anaesthetist will explain the pros and cons of each type of anaesthetic to you. You will usually be given injectable antibiotics before the procedure, after checking for any allergies. A special telescope is inserted into the bladder to see the stones. These are then broken up using a crushing instrument, a mechanical disintegration probe or a laser. The stone fragments are removed from the bladder and a catheter inserted.

After the procedure

The catheter will be removed within 24-48 hours following which you will be able to pass urine normally. Some burning, frequency of urination and bleeding are common within the first 24-48 hours after catheter removal. It is not unusual for a plain X-ray of your abdomen to be performed on the day after surgery to confirm that all the stone fragments have been removed. The average hospital stay is 5 days.

Potential side effects