by Neff DM

Definition

Cystolitholapaxy is a procedure to break up bladder stones into smaller pieces and remove them. Bladder stones are minerals that have built up in the bladder. Ultrasonic waves or lasers may be delivered through a tool called a cystoscope to break up the stones.

Bladder Stone
si1713 bladder stone
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Reasons for Procedure

This procedure is done to treat bladder stones.

Possible Complications

Complications are rare, but all procedures have some potential risk. Your doctor will review potential problems, like:

  • Urinary tract infection
  • Bladder tear or damage
  • Bleeding
  • Reaction to the anesthesia
  • Infection
  • Damage to internal tissue or structures

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic disease such as diabetes or obesity

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Physical exam and medical history
  • Blood and urine tests
  • Imaging tests to evaluate the bladder and surrounding structures

Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.

Other things to remember before the procedure:

  • Arrange for a ride home from the care center.
  • If instructed by your doctor, do not eat or drink for 8 hours before the procedure.

Anesthesia

This procedure can be done under local, spinal , or general anesthesia. It will block any pain. Sedation may also be used to ease anxiety.

With local anesthesia, a special jelly or fluid will be inserted into your urethra. This will numb the area. If you are having spinal anesthesia, it will be injected into your spine. General anesthesia will make you stay asleep during the procedure.

Description of Procedure

An instrument called a cystoscope will be placed through the urethra and into the bladder. The cystoscope has a camera that allows the doctor to see the stone. An ultrasonic probe or laser fiber is then passed through the cystoscope and used to fragment the stone. Stone fragments are flushed out of the bladder. The cystoscope is then removed.

Immediately After Procedure

Depending on the type of anesthesia used, you may be able to move around after the procedure. You may still have a catheter inside your urethra.

How Long Will It Take?

This is usually done in an outpatient setting. You will not need to stay overnight. The procedure takes 30-60 minutes depending on the size of the stones.

How Much Will It Hurt?

Anesthesia prevents pain during the procedure. Ask your doctor about medication to help with pain after the procedure.

Post-procedure Care

At the Care Center

After the procedure, the care center staff may provide the following care:

  • Monitor you while you recover from the anesthesia and/or sedation
  • Remove any IV needles and the catheter (unless you have trouble emptying your bladder and need to keep the catheter)
  • Help you to eat and move around again
  • Give you pain medication

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
At Home

During recovery, avoid difficult activity and heavy lifting until your doctor says it is okay to do so.

Call Your Doctor

Call your doctor if any of these occur:

  • Increasing pressure or pain while passing urine
  • Pain in the back or abdomen
  • Being unable to urinate
  • Changes in frequency, odor, appearance, or volume of urine
  • Signs of infection, including fever or chills
  • Blood or blood clots in urine after the first few days
  • Painful urination or a burning sensation after the first few days
  • Leaking of urine

If you think you have an emergency, call for emergency medical services right away.

RESOURCES

National Institute of Diabetes and Digestive and Kidney Diseases  https://www.niddk.nih.gov 

Urology Care Foundation  http://urologyhealth.org 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

The Kidney Foundation of Canada  https://www.kidney.ca 

References

Cystoscopy & ureteroscopy. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/diagnostic-tests/cystoscopy-ureteroscopy. Accessed January 29, 2021.

Cystoscopy for women. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/healthlibrary/test%5Fprocedures/gynecology/cystoscopy%5Ffor%5Fwomen%5F92,P07723. Accessed January 29, 2021.

Marickar YM, Nair N, Varma G, Salim A. Retrieval methods for urinary stones. Urol Res. 2009;37(6):369-376.

Revision Information

  • Reviewer: EBSCO Medical Review Board Adrienne Carmack, MD
  • Review Date: 03/2020
  • Update Date: 01/29/2021