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Cystolitholapaxy


Why is this procedure done?


The urinary tract is made up of the kidney, ureters, bladder, and urethra. The kidneys make urine and drain down into tubes called ureters. These ureters are connected to the bladder. The bladder then squeezes out the urine and it exits the body through the urethra. ‚  
Sometimes, salts and minerals in your urine build up and form stones. The stones are hard and can get stuck on their way out of the body. Some stones are too large and block the flow of urine. Others cause bleeding, pain, and infection. These stones need a way to break them up so that they can pass out of the body. ‚  
A cystolitholapaxy is a way the doctor can remove stones inside the bladder. A probe uses waves or lasers to break the stones down into very small pieces. It: ‚  
  • Removes stones inside the bladder
  • Looks for problems inside the lining of the bladder

What will the results be?


The bladder stones are broken into sand-like pieces. Then, they can easily pass through the urinary tract. ‚  

What happens before the procedure?


  • Your doctor will take your history. Talk to your doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • When you need to stop eating or drinking before your procedure.
    • Tell your doctor if you are allergic to iodine, shellfish, or shrimp.
  • Your doctor will do an exam and may order:
    • Lab tests
    • X-rays
    • Ultrasound
    • CT or MRI scan
  • You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?


  • Once you are in the operating room, the staff will put an IV in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. You may be asleep or awake during the procedure.
  • There are two ways to do the test:
    • Transurethral:
      • Your doctor will clean your genital area. Your doctor will put a thin flexible tube called a cystoscope through your urethra and into the bladder. This tube has a tiny lighted camera on the tip. Small tools can be used with this scope. Your doctor will put water into your bladder through the cystoscope. Your doctor will fill it until your bladder wall expands. You may feel bloated. Once your doctor sees the stone, the doctor will use a special tool to grab it. Your doctor will turn the tool on and break the stone. Your doctor may use another tool to catch the broken stone pieces. Your doctor will take all the tools out.
    • Percutaneous suprapubic:
      • Your doctor will clean your lower belly. Your doctor will make a small cut there to reach the bladder. Your doctor will put a thin flexible tube, called a cystoscope, into this cut. Small tools can be used with this scope. When your doctor sees the stone, the doctor will turn the tool on and break it. Your doctor may use another tool to catch the broken stone pieces. Your doctor will take all the tools out. Your doctor will close your cut with stitches or staples. Your doctor may place a drain tube in your belly. Your doctor will cover the wound with a clean bandage.
      • Your doctor may use an ultrasound machine while putting in the cystoscope.
      • Your doctor may put a different thin drain tube inside your urethra that passes into the ureter. This drain tube will help pass the stone pieces out of your body.
  • The procedure takes 30 to 60 minutes, based on the size of the bladder stones.

What happens after the procedure?


  • You will go to the Recovery Room. The doctor will tell you when you can go home.
  • You may feel some stinging pain on your genitals after the procedure. Your doctor will give you drugs for pain relief. You may feel sore. You may have problems passing urine for 24 hours.
  • There may be a tube in your urethra.
  • You may see some blood in your urine after the procedure.

What care is needed at home?


  • Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
  • Pieces of the bladder stone may pass in the urine for a few days and may cause mild to moderate pain. Your doctor may give you drugs for the pain. Take the drugs exactly as ordered by your doctor.
  • Drink 8 to 10 glasses of water each day. This will help flush the broken bladder stones out.
  • Your doctor may ask you to strain your urine using a filter. The filter will hold the stone pieces that will be used for testing. The doctor may ask you to keep any stones that you pass so that the doctor can see them.
  • You may have a tube coming out of your urethra. Keep this in place. Ask your doctor how to take care of it and how long it will be in place.
  • Be sure to wash your hands before and after touching your wound or dressing.
  • Empty your bladder as soon as you feel the need to.

What follow-up care is needed?


  • Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
  • If you were asked to filter your urine, you may need to bring the collected stones on your next visit.
  • If a tube is in your urethra, your doctor will set a time to remove it within a week.
  • If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.

What drugs may be needed?


The doctor may order drugs to: ‚  
  • Help your body pass the broken stones
  • Help with pain
  • Prevent infection

What problems could happen?


  • Bleeding
  • Urinary tract infection
  • Infection
  • Pain while passing pieces of bladder stone
  • Blocked flow of urine if stone pieces are too big to pass. Your urine amount will be less.

When do I need to call the doctor?


  • Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine or not able to pass urine, wound that will not heal.
  • Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
  • Pain does not go away even with drugs
  • Urine is more bloody or cloudy
  • Drainage is coming out of the urethra that smells bad or is yellow or green colored
  • You have little or no urine

Helpful tips


Dont delay going to the bathroom. It stretches and weakens the bladder. ‚  

Where can I learn more?


NHS Choices ‚  
http://www.nhs.uk/Conditions/Bladder-stones/Pages/Treatment.aspx ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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