Cystolithotripsy is a surgical treatment for the patients who are suffering from symptomatic bladder stones including open cystolithotomy, percutaneous cystolithotomy, or cystoscopic laser lithotripsy with stone extraction. The part of cystolithotripsy from past 10 years has undergone a remarkable evolution, due to the advent of holmium laser. Cystolithotripsy (or) CLT is the removal of bladder stones by the procedure of crushing (or) destruction of the stones.
The major advantage of CLT is that it is very safe and effective treatment for the removal of the bladder stones and no incision is made in the body and the patient can be discharged from the hospital in the next morning. Stone that were routinely removed by making an open incision and then broken of the stones into multiple smaller pieces and are removed from a natural body opening (the urethra), by avoiding both the pain and the recovery of an open incision. Bladder/urethral anatomy, Bladder stone size all play major roles in determining outcomes and operative approach.
PROCEDURE OF CLT:
- Initially measurement of stone size through ultrasound in the largest diameter.
- Then patients were operated by giving spinal or general anesthesia.
- Nephroscope with 28fr sheath were used transurethrally along with 2 cm probe called lithoclast probe.
- Initially small fragments were achieved by swiss lithoclast.
- Later bigger fragments were dealt with stone punch. At last all the fragments were evacuated with ellick evacuator.
- Then bladder was drained with foley’s catheter for 24 hours.
CARE TO BE TAKEN:
care to be taken after the surgery like taking food that contains high salt content that drastically increases the quantity of calcium in the urine, so that patients with calcium stones should decrease their sodium intake in their diet to 3 grams or less a day. Sodium will also increases the levels of urate, which is a crystalline substance that leads to the formation of calcium oxalate stones, so increase the intake of fiber foods such as phytate found in legumes, wheat, and rice bran help protect against kidney stones.