title: Transurethral cystolitholapaxy with the AH-1 stone removal system for the treatment of bladder stones of variable size.
abstract: BACKGROUND
  The treatment of large volume bladder stones by current equipments continues to be a management problem in both developing and developed countries. AH-1 Stone Removal System (SRS) invented by us is primarily used to crush and retrieve bladder stones. This study evaluated the safety and efficiency of transurethral cystolitholapaxy with SRS for the treatment of bladder stones of variable size.
  
  
  METHODS
  SRS, which was invented by Aihua Li in 2007, composed by endoscope, continuous-flow component, a jaw for stone handling and retrieving, lithotripsy tube, handle, inner sheath and outer sheath. 112 patients with bladder stones were performed by transurethral cystolitholapaxy with SRS since 2008. We compare the surgical outcome to bladder stones of variable size, and evaluate the surgical efficiency and safety.
  
  
  RESULTS
  Characteristics of patients and stone removal time in variable size were evaluated. To patients with single stone, stone size was 1.35 ± 0.37 cm and the operating time was 5.50 ± 3.92 min in Group A. Stone size was 2.38 ± 0.32 cm and the operating time was 11.90 ± 9.91 min in Group B. Stone size was 3.30 ± 0.29 cm and the operating time was 21.92 ± 9.44 min in Group C. Stone size was 4.69 ± 0.86 cm and the operating time was 49.29 ± 30.47 min in Group D. The difference was statistically significant between the four groups. Among them, 74 (66.07%) patients accompanied with benign prostatic hyperplasia (BPH) were treated by transurethral resection of the prostate (TURP) simultaneously. Compared between the four groups, the difference of the TURP time was not statistically significant, P >0.05. No significant complication was found in the surgical procedure.
  
  
  CONCLUSIONS
  Transurethral cystolitholapaxy with SRS appears to be increased rapidity of the procedure with decreased morbidity. It is a safe and efficient surgical management to bladder stones. This endoscopic surgery best fits the ethics principle of no injury; meanwhile, the accompanied BPH could be effectively treated by TURP simultaneously.
authors.affiliation: Department of Urology, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, 200090, China. Li121288@aliyun.com.
authors.forename: Aihua
authors.initials: A
authors.lastname: Li
authors.affiliation: Department of Urology, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, 200090, China. 15800397667@163.com.
authors.forename: Chengdong
authors.initials: C
authors.lastname: Ji
authors.affiliation: Department of Urology, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, 200090, China. wanghui97021@163.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Urology, the 411th Hospital of PLA, Shanghai, 200081, China. zyhml103@sina.com.
authors.forename: Genqiang
authors.initials: G
authors.lastname: Lang
authors.affiliation: Department of Urology, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, 200090, China. julietlhh@sina.com.
authors.forename: Honghai
authors.initials: H
authors.lastname: Lu
authors.affiliation: Department of Urology, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, 200090, China. liusikuan@126.com.
authors.forename: Sikuan
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Urology, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, 200090, China. nxyclww@163.com.
authors.forename: Weiwu
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Urology, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, 200090, China. zbh426@sohu.com.
authors.forename: Binghui
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Urology, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, 200090, China. drawrof@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Fang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003558:Cystoscopy / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010147:Pain Measurement; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014521:Urethra; D001744:Urinary Bladder Calculi / Q000175:diagnosis / Q000601:surgery*