Minimally invasive percutaneous suprapubic cystolithotripsy: an effective treatment for bladder stones with urethral strictures

To compare the therapeutic efficacy of minimally invasive percutaneous cystolithotripsy (MPCCL) with open surgery on bladder stones with urethral strictures. We reviewed the clinical characteristics and outcomes of 37 patients with bladder calculi with urethral strictures in our institute between March 2004 and December 2012. Of them, 21 patients were treated with MPCCL, and 16 underwent open surgery. The mean stone size was 5.53 cm (range 1.1-7.8 cm); 12 patients had single stones, and 25 patients had multiple stones. Transurethral cystolithotripsy in all of the patients failed because of the urethral strictures. MPCCL was performed through a 20 F peel-away sheath. Fragmentation and removal was performed with an 8-9.8 F ureteroscope and the Swiss Lithoclast. Each patient was cleared their stone burden with a single procedure, and there were no major complications. The mean operative time in the MPCCL group was 18.2 (11-35) minutes, while it was 32.3 (23-52) minutes (P=0.023) in the open surgery group. In the open surgery group, urinary leakage occurred in 3 patients (P=0.045) and a wound infection developed in 5 patients (P=0.012). The mean urethra catheter time was 2.5 days in the MPCCL group and 8.6 days in the open surgery group (P=0.016). The mean hospital stay in the MPCCL group was 2.6 days, whereas it was 3.5 days in the open surgery group (P=0.018). Compared with open surgery, MPCCL is a highly effective and safe technique for bladder stones in patients with urethral strictures.