title: Combined usage of Ho:YAG laser with monopolar resectoscope in the treatment of bladder stone and bladder outlet obstruction.
abstract: OBJECTIVE
  Bladder 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.
  
  
  METHODS
  Patients 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.
  
  
  RESULTS
  We 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.
  
  
  CONCLUSIONS
  Combination 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.
authors.affiliation: Jian Hui Wu, Department of Urology, Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, No. 23 Pingjiang Road, Tianjin 300211, China.
authors.forename: Jian Hui
authors.initials: JH
authors.lastname: Wu
authors.affiliation: Kuo Yang, Department of Urology, Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, No. 23 Pingjiang Road, Tianjin 300211, China.
authors.forename: Kuo
authors.initials: K
authors.lastname: Yang
authors.affiliation: Qian Liu, Department of Urology, Tianjin First Center Hospital, No.24 Fukang Road, Nankai District, Tianjin 300192, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Shi Qiang Yang, Department of Urology, Tianjin First Center Hospital, No.24 Fukang Road, Nankai District, Tianjin 300192, China.
authors.forename: Shi Qiang
authors.initials: SQ
authors.lastname: Yang
authors.affiliation: Yong Xu, Department of Urology, Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, No. 23 Pingjiang Road, Tianjin 300211, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
keywords: Laser; Lasers; Lithotripsy; Prostatic hyperplasia; Solid-state; Transurethral resection of prostate; Urinary bladder calculi; Urinary bladder neck obstruction
references.citation: J Pak Med Assoc. 2011 Jul;61(7):628-31
references.pmid: 22204233
references.citation: Arab J Urol. 2012 Sep;10(3):301-6
references.pmid: 26558041
references.citation: J Urol. 2012 Mar;187(3):914-9
references.pmid: 22264464
references.citation: Int Urol Nephrol. 2007;39(1):173-7
references.pmid: 17273902
references.citation: J Endourol. 2003 Sep;17(7):505-9; discussion 509
references.pmid: 14565884
references.citation: J Endourol. 2009 Jul;23(7):1145-9
references.pmid: 19530903
references.citation: Eur Urol. 2013 Jul;64(1):118-40
references.pmid: 23541338
references.citation: Urology. 2002 May;59(5):688-91
references.pmid: 11992841
references.citation: Urology. 2005 Jun;65(6):1219-20
references.pmid: 15922419
references.citation: Urology. 2003 Aug;62(2):333-6; discussion 336
references.pmid: 12893346
references.citation: Urology. 2012 May;79(5):980-6
references.pmid: 22119259
references.citation: J Endourol. 2014 Oct;28(10):1178-82
references.pmid: 23384337
references.citation: J Endourol. 2009 Jul;23(7):1151-5
references.pmid: 19530944
references.citation: J Endourol. 2001 Oct;15(8):851-3
references.pmid: 11724128
references.citation: BJU Int. 2007 Mar;99(3):595-600
references.pmid: 17026589
references.citation: Urology. 2004 Nov;64(5):1026-7
references.pmid: 15533500