title: Novel technique of cytolithotripsy for large bladder stones.
abstract: BACKGROUND
  We evaluated a minimally invasive surgical technique involving a single percutaneous access with a laparoscopic trocar under video-cystoscopic vision for managing large bladder stones. All patients were candidates for open surgery.
  
  
  METHODS
  Fourteen patients with bladder stones larger than 3 cm in diameter or multiple stones were treated with this technique. The procedure involved the percutaneous placement of a laparoscopic trocar under cystoscopic control and the introduction of a rigid nephroscope into the bladder. Stones were cleansed via fragmentation or direct removal.
  
  
  CONCLUSIONS
  The technique was successful in all cases, resulting in controlled, stone-free bladders; there were no surgical complications. The mean operation time was comparable to that of standard management. All patients discharged uneventfully. None reported urethral stricture during the 24-month follow-up period. Percutaneous cystolithotripsy under endoscopic control is easy to perform and should be considered as an alternative for large or multiple bladder stones as it decreases the risk of urethral stricture.
authors.affiliation: Department of Urology, Ministry of Health, Istanbul Training and Research Hospital, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Toktas
authors.forename: Vural
authors.initials: V
authors.lastname: Sacak
authors.forename: Erkan
authors.initials: E
authors.lastname: Erkan
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kocaaslan
authors.forename: Murat
authors.initials: M
authors.lastname: Demiray
authors.forename: Erdinc
authors.initials: E
authors.lastname: Unluer
authors.forename: M Emin
authors.initials: ME
authors.lastname: Ozyalvacli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D020684:Cystoscopes; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008096:Lithotripsy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016896:Treatment Outcome; D001744:Urinary Bladder Calculi / Q000473:pathology* / Q000601:surgery*
keywords: Bladder stones; percutaneous cystolithotripsy; urethral stricture