Jay Dharmashi
Assistant Professor Dept. of Urology Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences Sawangi (Meghe), Wardha
Abhijit Dhale
Associate Professor Dept. of Urology Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences Sawangi (Meghe), Wardha
Abstract
Background: Lower urinary tract symptoms are the most typical side effects of a blocked bladder outlet (BOO). BOO can be caused by a variety of physiological and anatomical factors. For all age groups, including patients who had a laparotomy and had an abdominal scar, we evaluated the safety and effectiveness of a minimally invasive surgical technique involving ultrasound guided supra-pubic percutaneous access with desired size amplatz sheath placement under direct vision for managing bladder stones.
Aims & objectives: The purpose of this study is to see how safe and successful ultrasound-guided suprapubic cystolithotripsy is for vesical calculi.
Methods: This procedure was used on 64 individuals who had a single or multiple bladder stones measuring 10-30 mm in diameter. All of the patients were open surgery candidates. The procedure was performed under direct cystoscopic vision with a nephroscope inserted suprapubically into the bladder. The stones were shattered with a lithotripter, and stone clearance was measured with an ultrasonogram.
Results: There were six females and 58 men in the group. The patients ranged in age from 45.6 to 18.6 years. The stone's average size was 2.45 0.4 cm. The average number of stones was four, with the range being one to fifteen. The average surgical time was 36. 13 minutes, and the average hospital stay was 3. 1 days. 4 of the 64 patients (6.25 percent) had already had a laparotomy and had abdominal scars. Every single one of the 64 patients (100%) had a stone-free bladder. Two patients experienced a little urine leak at the suprapubic catheter site that went away within 24 hours. There were no intraoperative or postoperative problems. On the fifth postoperative day, all patients were discharged.
Conclusion: Percutaneous cystolithotripsy under ultrasound guidance is safe and comfortable, and it should be considered in patients with large or multiple bladder stones, as well as those who have had a laparotomy and have scars on their abdomen. It reduces the risk of urethral stricture and trocar-induced bowel or vascular injuries.
Keyword: Bladder stones, ultrasound guidance, minimally invasive, endoscopic bladder surgery