Dr Jo Schoeman
Urological Surgeon

        

Cysto-lithopaxy

Product Summary: AMA rates

Endoscopic procedure used for breaking up a bladder stone. Either with a stone crusher or laser

Item Number: 36863, 105

Why is it done?

To investigate:

  • To break up a bladder calculus (stone).

Risk factors:

  • Bladder outflow obstruction.
  • BPH with chronic retention.
  • Urethral stricture.
  • Neurogenic bladder.
  • Renal calculi disease.
  • Metabolic disorders.
  • Malnutrition.
  • Chronic infections.
  • Foreign objects in bladder.

Pre-requirements

  • An informed consent is required from the patient.
  • Female patients should confirm that they are not pregnant.
  • Patients may not eat or drink from midnight the previous evening.
  • Patients are to refrain from smoking before the procedure.
  • Patients allergic to IODINE / CHLORHEXIDINE should clearly state this to theatre staff and to Dr Schoeman.
  • Patients with cardiac illnesses require a Cardiologist/ Physician’s report.
  • A chest X-ray is required for patients with lung disease.
  • Where required, Pre-Op blood tests are required 4 days before the procedure
  • This is a day surgery procedure, unless more involved pathology is suspected or found during the procedure.

How is it done?

  • A cystoscopy is performed by placing a camera in the urethra with the help of a lubricant jelly and an irrigant (fluid).
  • The bladder is then distended with fluid (saline).
  • The inside of the bladder is viewed for pathology.
  • If any suspicious lesions are seen, a biopsy will be taken.
  • Stone crushing is attempted with a lithotrite ( a large crushing jaw-device).
  • If the calculus is too large, laser will be utilised.
  • Antibiotics may be given to prevent infection.

What to expect after the procedure?

  • Hematuria ( blood in your urine)
  • You will have a n indwelling catheter (IDC), which will remain in your bladder until your urine is clear.
  • You may have a continuous bladder irrigation with Saline to help clear the bleeding.
  • Pain on initial passing of urine when the catheter is removed.
  • Bladder infection ranging from a burning sensation to, fever, to puss (rare).
  • Delayed allergic reaction to IODINE.
  • Lower abdominal discomfort which will persist for a few days.
  • NB! Each person is unique and for this reason symptoms vary.

What next?

  • This all depends on what is found during the procedure. All the options will be discussed in detail.
  • There may be some blood in the urine. This can be remedied by drinking plenty of fluids until it clears.
  • A ward prescription will be issued to patients on discharge, for own collection at any pharmacy.
  • Patients should schedule a follow-up appointment within 1 month to discuss the etiology of the calculus as well as what other procedures may be involved to prevent this from occurring again.
  • Please don’t hesitate to direct all further queries to Dr Schoeman.

Cysto-Lithopaxy Cysto-Lithopaxy (379 KB)