Bladder Stones Cystolithotripsy
Bladder stones are formed secondary to obstruction to the flow of urine from the bladder as in
non cancerous enlargement of the prostate. Such stones tend to be very large as the bladder
obstruction sets in over a long period of time. Stones can also form after the stones drop
down from the ureter and get trapped in the bladder.
Bladder stones often cause – strangury – sudden painful stoppage of urine while urinating.
The can also present themselves with recurrent or persistent urinary infection.
Besides the desease symptoms , Urine, blood tests, X-rays and Ultrasound Scan will be required to diagnose the condition. Additional tests to determine the cause for bladder stone formation such as measurement of speed of Urine flow- uroflowmetry and CT scan to determine the presence of other stones in the kidney or ureter may be required.
Most bladder stones can be treated by cystolithotripsy. Here a telescope is passed into the bladder through your water passage under anaesthesia and the stone powdered (litho – stone , tripsy – powder). However, very large stones may require open sugery and involves a 7 cm wound in the lower abdomen.
If a definitive cause for the stone formation is also diagnosed, such as prostate enlargement, this can also be treated at the same time.
Pre Operative Work up: You will be required to have a basic medical check up to assess fitness. This will be done by your Urologist, Anaesthetist and Physician. For this some basic tests such as blood tests, ECG and Chest X-ray will be done.
This is done prior to fixing date for surgery.
Admission will be one day before surgery. Written instructions will be given to you before hand so that you can be admitted directly into the ward from the reception without having to wait again at the outpatient department.
You will be given laxatives on this day so that you have a good bowel movement the next day morning.
You will be informed about the surgery time.
Day of surgery:
- You should be fasting – no solids or liquids – from 6 hours before surgery.
- Surgery takes about 2 hours – but depends on the size and hardness of the stone.
- You will have a catheter – tube in your urethra- for your comfort. This will be removed the next day.
- If you required open surgery, in addition to stitches in the lower abdominal wound you will have a drainage tube also from near the wound.
- You will be shifted from the post operative ICU to your room 4 hours after completion of surgery.
- Liquid diet is allowed on reaching the room but is better avoided.
1st Post Operative Day
The urinary catheter is removed. You will be allowed to move freely and have a norma diet.
You will be allowed to go in the evening or the next day.
One more day of rest is required at home.
For Open Stone Removal in case of very large stones:
The catheter is usually removed after 4 days. By which time the drainage would have siezed.
The drainage tube is removed next day if there is no drainage on removal of the catheter.
You will be allowed to go home the next day.
10 days rest after discharge is required.
You can have your bath at home. There is no harm in getting the stiches wet.
Out patient review:
Usually after 10 days to see if there is any infection.
After open surgery, the sticthes are removed.