Bladder Stones

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The Operation

What to expect prior to the surgery

To assure your safety to undergo the procedure testing needs to be performed before surgery.

These should include:

  • History and physical exam
  • Ekg (electrocardiogram)
  • Chest x-ray
  • Blood tests
  • Cbc
  • Pt / ptt
  • Comprehensive metabolic panel
  • Urinalysis, urine culture

If you have a history of heart problems, we may request additional clearance from your cardiologist, which may involve additional testing such as an echocardiogram or nuclear medicine stress test. These tests would be ordered by your primary care physician or cardiologist depending on your medical history.

Preparing for surgery

  • Drink only clear fluids for a 24-hour period prior to the date of your surgery.
  • Do not eat or drink anything after midnight the night before the surgery.
  • If you are having open surgery, you may be asked to drink one bottle of magnesium citrate (can be purchased at your local pharmacy) the evening before your surgery.
  • Aspirin, motrin, ibuprofen, advil, alka seltzer, vitamin e, ticlid, coumadin, lovenox, celebrex, voltaren, vioxx, plavix and some other arthritis medications can cause bleeding and should be avoided one week prior to the date of surgery. Please contact your surgeon's office if you are unsure about which medications to stop prior to surgery. Do not stop any medication without contacting the prescribing doctor to get their approval.
  • Hospitalization is usually not necessary unless secondary procedures are to be performed or the open surgical approach is used. Have someone available to escort you home if your doctor plans to discharge you home after the surgery.

The operation

Typically, the length of the operation is anywhere from one to four hours depending on the extent of the operation. The surgery is performed either through the urethra (transurethral cystolitholapaxy), or through a small 1cm incision in the lower abdomen (percutaneous suprapubic cystolitholapaxy), or through a lower abdominal incision (open surgery). A urethral catheter, and/or a suprapubic catheter is typically placed at the end of the procedure. The need for continuous bladder irrigation (cbi) will be determined by your doctor. The catheters are typically removed prior to your discharge from the hospital. The duration of the catheterization may be longer depending on the extent of your surgery.

Potential risks and complications

Although this procedure has proven to be very safe, as in any surgical procedure there are risks and potential complications. The complication rates are similar when compared to the open surgery. Potential risks include:

  • Bleeding: blood loss during this procedure is minimal and only rarely is a blood transfusion necessary.
  • Infection: all patients are treated with broad-spectrum intravenous antibiotics prior to starting the surgery to decrease the chance of infection from occurring after surgery. If you develop any signs or symptoms of infection after the surgery (fever, drainage from the incision, urinary frequency/discomfort or pain) or anything else that you may be concerned about, please contact us at once.
  • Hernia at incision site is uncommon.
  • Tissue / organ injury: although uncommon, possible injury to surrounding tissue and organs including bowel, blood vessels.
  • Conversion to open surgery: the minimally invasive approach may require conversion to the standard open operation if difficulty is encountered. This would result in a larger standard open incision, and possibly a longer recuperation period.
  • Failure: your bladder stones may be too numerous to be cleared in a single operation with the minimally invasive approach. If this occurs additional surgery will be necessary.
  • Other complications: these are uncommon and include: low sodium (hyponatremia) and bladder perforation which may require open surgical repair of the bladder and longer duration of catheterization.