Percutaneous suprapubic cystolithotripsy under local anesthesia.
OBJECTIVE
To assessed the feasibility and effectiveness of percutaneous cystolithotripsy under local anesthesia in selected patients.


METHODS
Thirty-one patients with bladder stones of different etiologies underwent percutaneous cystolithotripsy under local anesthesia. Suprapubic access was obtained with ultrasound guidance, and fragmentation of the stone was performed using the Swiss lithoclast. Suprapubic and transurethral catheters were placed postoperatively.


RESULTS
No major intraoperative complications occurred. The whole procedure was well tolerated, and no significant differences were found in the mean pain score between the percutaneous suprapubic cystolithotripsy group and a group of male patients who underwent rigid cystoscopy under local anesthesia (P = 0.35). Complete stone clearance was achieved in all but 1 patient (96.78%). Bladder irrigation because of gross hematuria was needed in 5 patients, but no blood transfusion was required. Fever developed in 1 patient and was treated with intravenous antibiotics. The average hospitalization was 2.3 days (range 2 to 5). After a mean follow-up of 10 months, no recurrent stone developed.


CONCLUSIONS
Percutaneous suprapubic cystolithotripsy under local anesthesia is a safe and effective technique to remove bladder calculi. Thus, it may be used as an alternative treatment option in selected patients.
Tzortzis
Vassilios
V
Department of Urology, University of Thessaly School of Medicine, Larissa, Greece. tzorvas@otenet.gr
Aravantinos
Evangelos
E
Karatzas
Anastasios
A
Mitsogiannis
Iraklis C
IC
Moutzouris
Georgios
G
Melekos
Michael D
MD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011677:Punctures; D018084:Ultrasonography, Interventional; D001744:Urinary Bladder Calculi / Q000628:therapy*
D000779:Anesthetics, Local; D008012:Lidocaine