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Torricelli FC et al, 2013: Surgical management of bladder stones: literature review

Torricelli FC, Mazzucchi E, Danilovic A, Coelho RF, Srougi M
Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil


Abstract

Bladder stones are rare and most cases occur in adult men with bladder outlet obstruction. Currently, there are few data on the best treatment of this disease. The aim of this review is to discuss some aspects of pathogenesis and treatment approaches for bladder lithiasis. A comprehensive search of the database of the "National Library of Medicine" /pubmed was conducted with the following key words and descriptors: "bladder" or "vesical" associated with "calculus", "stone" or "lithiasis", and "cistolithotripsy ". One hundred and seventy-one articles were identified. The articles were independently assessed by two reviewers with expertise in urolithiasis. They were included in the study when the results, complications and follow-up were clearly reported. In the end, 32 studies met the inclusion criteria. Several options for the treatment of bladder lithiasis are available, but no randomized trials comparing them. Different rates of calculus-free patients are described in each of them, as follows: extracorporeal shock wave lithotripsy (75-100%), transurethral cistolithotripsy (63-100%), percutaneous cistolithotripsy (89-100%) and open surgery (100 %). The percutaneous approach has lower morbidity, with similar results to the transurethral treatment, while extracorporeal lithotripsy has the lowest rate of elimination of calculi and is reserved for patients at high surgical risk.

Rev Col Bras Cir. 2013 May-Jun;40(3):227-33.
PMID:23912371 [PubMed - in process]

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Hans-Göran Tiselius on Thursday, 16 January 2014 09:58

The article is a review of how bladder stones best should be treated. The basic concept for management of patients with bladder stones is to simultaneously treat the outflow obstruction that is the cause of stone formation. When just stone removal is considered acceptable several alternative treatments are available among which SWL is one. Inasmuch as SWL is a non-invasive method it might be preferred for patients at high risk, but it is of note that the results of SWL were inferior to those obtained with endourologic cystolithotripsy and open surgery. SWL of bladder stones can, however, be successful and if combined with a secondary cystoscopy result in high stone-free rates.

Treatment of bladder stones in 244 patients as reported in the literature resulted in a mean stone-free rate of 91.4%. The success rate varied between 72 and 100 % and the number of sessions between 1
and 5.

So, in elected cases SWL for a bladder stone is an acceptable treatment which, however, not always is technically easy.

Hans-Göran Tiselius

The article is a review of how bladder stones best should be treated. The basic concept for management of patients with bladder stones is to simultaneously treat the outflow obstruction that is the cause of stone formation. When just stone removal is considered acceptable several alternative treatments are available among which SWL is one. Inasmuch as SWL is a non-invasive method it might be preferred for patients at high risk, but it is of note that the results of SWL were inferior to those obtained with endourologic cystolithotripsy and open surgery. SWL of bladder stones can, however, be successful and if combined with a secondary cystoscopy result in high stone-free rates. Treatment of bladder stones in 244 patients as reported in the literature resulted in a mean stone-free rate of 91.4%. The success rate varied between 72 and 100 % and the number of sessions between 1 and 5. So, in elected cases SWL for a bladder stone is an acceptable treatment which, however, not always is technically easy. Hans-Göran Tiselius
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