Retrospective audit for preoperative factors and clinical outcomes in patients undergoing bladder

Abstract

BACKGROUND: Five percent of urinary tract stones are found in the urinary bladder. Bladder stones are responsible for 8% of urolithiasis related mortalities. We have conducted a study and evaluated the effectiveness, safety and the outcome of transurethral cystolithotripsy using a rigid cystoscope under general anaesthesia.

METHODS: A retrospective study conducted at Mater Dei Hospital in Malta, from 2004 until 2020. Information obtained from medical records, information technology hospital system and department theatre list. 201 patients were included who all underwent cystolithotripsy with or without transurethral resection of prostate (TURP) or bladder neck incision (BNI). Approval to conduct the study was obtained after fulfilling all requirements requested by the University Research Ethics Committee of Malta, as well as obtaining approval of the CEO of Mater Dei Hospital in line with applicable hospital protocols.

RESULTS: The mean age was 65 years, ranging between 21 and 89. Overall, the procedure was well tolerated and there were no major peri-operative complications. The hospital stay ranged between 1 to 33 days with an average of 3 days. Follow up average was 4.3 years. The maximum period with bladder catheter was 18 days before a successful trial without catheter. The majority of patients remained catheter free in the long term with a minority still requiring conservative measures for the relief of lower urinary tract symptoms.

CONCLUSIONS: Transurethral cystolithotripsy using a rigid cystoscope under general anaesthesia is a safe and effective technique for the treatment of different sizes of bladder calculi.