• Pak J Med Sci · Jul 2014

    Combined usage of Ho:YAG laser with monopolar resectoscope in the treatment of bladder stone and bladder outlet obstruction.

    • WuJian HuiJHJian Hui Wu, Department of Urology, Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, No. 23 Pingjiang Road, Tianjin 300211, China., Kuo Yang, Qian Liu, YangShi QiangSQShi Qiang Yang, Department of Urology, Tianjin First Center Hospital, No.24 Fukang Road, Nankai District, Tianjin 300192, China., and Yong Xu.
    • Jian Hui Wu, Department of Urology, Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, No. 23 Pingjiang Road, Tianjin 300211, China.
    • Pak J Med Sci. 2014 Jul 1; 30 (4): 908-13.

    ObjectiveBladder stones in elderly men are commonly associated with bladder outlet obstruction, and many different treatment modalities have been presented for both these conditions. To evaluate the effectiveness and safety of a novel method concerning spontaneous usage of both monopoplar transurethral resection of the prostate and Holmium Laser cystolithotripsy, we compared the transurethral use of resectoscope and cystoscope lithotripsy approaches retrospectively.MethodsPatients data of one hundred and nine male patients with benign prostatic hyperplasia (BPH) and bladder stone(s) were analyzed retrospectively. Two groups of patients were compared: Group I was treated with combination of transurethral holmium laser cystolithotripsy (HLC) and transurethral resection of the prostate (TURP) using the 24F resectoscope, and group II used 22F cystoscope and 24F resectoscope for treating both these conditions.ResultWe reviewed the records of 109 patients undergoing transurethral cystolithotripsy with holmium laser and simultaneous TURP. The mean bladder stone size were 3.6±1.5 cm in Group-I and 3.7±1.1 cm (mean 3.8) in Group-II (p>0.05). The mean operation time of Group-I and Group-II was 49.0±22.5 minutes and 79.0±28.5 minutes, respectively (p<0.05). Stone fragments were removed completely and TURP procedures were done successfully in all of the patients. Mild hematuria was found more frequently in Group-II (22.2%), and four (7.4%) patients had urethral stricture in the same group during the late follow-up.ConclusionCombination of transurethral laser cystolithotripsy and TURP using the same 24F resectooscope is an effective, safe and economical treatment for bladder stones in BPH patients. It is minimally invasive and involves and has lower complication rates and shorter hospital stay. However, this combined approach should be taken in the treatment of calculus within 4 or 5 centimeters.

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