Stones occur within the urinary bladder due to incomplete bladder emptying, urinary stasis, and/or chronic bladder infections. With time, the urine that is not voided begins to harbor bacteria and contain higher amounts of mucus, sediment and urinary minerals, eventually resulting in a bladder calculus. Surgical options for patients with symptomatic bladder stones include open cystolithotomy, percutaneous cystolithotomy, or cystoscopic laser lithotripsy with stone extraction (cystolithalopaxy – meaning “a look into the bladder to crush a stone.”). Your bladder/urethral anatomy, your bladder stone size, and body habitus all play major roles in determining outcomes and operative approach. Also, whether or not a prostate procedure is necessary at the time of stone removal is an important consideration for men with enlarged prostates and bladder stones.
The role of cystolithalopaxy over the last ten years has undergone a dramatic evolution, due to the advent of holmium laser. Stone that were routinely removed using an open incision may now be broken into multiple smaller pieces and removed through a natural body opening (the urethra), avoiding both the pain and the recovery of an open incision.