title: Minimally invasive surgery for patients with bulky bladder stones and large benign prostatic hyperplasia simultaneously: a novel design.
abstract: OBJECTIVE
  To determine the efficacy and safety of a novel minimally invasive design for treating bulky vesical calculi and large benign prostatic hyperplasia (BPH) simultaneously.
  
  
  METHODS
  76 patients with large bladder stones (>4 cm) and large BPH (≥50 cm³) were treated from August 2008 to January 2011. 38 patients (group 1) underwent transurethral cystolithotripsy followed by transurethral resection of the prostate (TURP), 38 patients (group 2) received percutaneous cystolithotripsy within a laparoscopic entrapment bag and TURP by two surgeons simultaneously. 72 patients were followed up for 1 year. Patient demographics, perioperative parameters and follow-up data were compared.
  
  
  RESULTS
  Patient baseline characteristics were comparable in the two groups. In group 1, 3 patients converted to open surgery and received blood transfusion, 4 patients had postoperative fever, 2 had residual stones and 1 developed urethral stricture postoperatively. In group 2, the mean total operative and the operative times for stone management were 71.6 and 30.1 min, respectively, the mean hemoglobin decrease was 0.80 g/dl, no patients received blood transfusion and no complications occurred, signiﬁcantly superior to group 1.
  
  
  CONCLUSIONS
  Percutaneous cystolithotripsy using a laparoscopic entrapment bag associated with TURP by two surgeons simultaneously is a highly effective, safe and minimally invasive method for managing large vesical calculi and large BPH.
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital, Yantai, PR China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Zhao
authors.forename: Lei
authors.initials: L
authors.lastname: Shi
authors.forename: Zhenli
authors.initials: Z
authors.lastname: Gao
authors.forename: Qingzuo
authors.initials: Q
authors.lastname: Liu
authors.forename: Ke
authors.initials: K
authors.lastname: Wang
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
mesh_terms: D000368:Aged; D005334:Fever; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008096:Lithotripsy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012008:Recurrence; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome; D001744:Urinary Bladder Calculi / Q000601:surgery*; D001748:Urinary Bladder Neck Obstruction / Q000601:surgery*