Bladder Stones
Minimally invasive approaches
Transurethral cystolitholapaxy
A cystoscopy is performed to visualize the stone. Then, an energy source such as special high energy sound waves (ultrasound), electrical energy (electrohydraulic lithotripsy, or EHL), or laser, is used to crush the stones until the fragments are small enough to be removed through the cystoscope. No incision is made in this approach. An indwelling catheter may be required at the end of your procedure.
Percutaneous suprapubic cystolitholapaxy
This is often used for stones that are too large for the transurethral approach and in children because their small urethra cannot accommodate the instruments required for the transurethral cystolitholapaxy procedure. In this approach, a small incision is made in the lower abdominal wall. It allows your doctor to use larger instruments for faster stone fragmentation and removal. An indwelling catheter may be required at the end of your procedure. An additional suprapubic catheter may also be left in place as determined by your doctor.
Additional procedures:
If your bladder stones were caused by obstruction from an enlarged prostate, your doctor may decide to perform a transurethral resection of the prostate (TURP) at the completion of the stone removal.
Open suprapubic cystolithotomy (open surgery)
This method is often employed to remove stones that are too large for the minimally invasive approaches discussed above. Your doctor may also decide to use this approach if you require another surgery (such as open prostatectomy or excision of a bladder diverticulum on your bladder or prostate. An open prostatectomy may be necessary if you have a very large prostate not amenable to a minimally invasive procedure and/or a bladder diverticulum. Your doctor will discuss the need for any additional procedures if they apply to your particular case. With this approach, an incision is made in the lower abdomen to access the bladder and remove the stones. An indwelling urethral catheter, and possibly, a second catheter through the lower abdomen (suprapubic catheter) may be left in place, depending on the extent of your surgery.
