Cystolitholapaxy Surgery in Delhi, India

Cystolitholapaxy is a surgical procedure to break down stones in the bladder. Bladder stones occur due to the accumulation of minerals either in the bladder or the kidney, causing pain as they grow in size. If originated in the kidney, they may move to the bladder through the ureter and eventually cause difficulty and pain while urinating.

With the help of an instrument known as a cystoscope, lasers or ultrasonic waves fragment bladder stones and ensure the removal of any pending pieces. This operation is safe and minimally invasive.

Alternate Name of Cystolitholapaxy Surgery

The scientific name is cystolitholapaxy.

Body Location

The urinary bladder.

Cystolitholapaxy Procedure Type

• Transurethral Cystolitholapaxy: Minimally invasive surgery
• Percutaneous Cystolitholapaxy: Percutaneous surgery

Preparation for Cystolitholapaxy Surgery

A series of tests are conducted before the surgery, including:

• To check the electrical activity of the heart before surgery.
• To ensure that the patient is completely fit for surgery.
• To detect high levels of specific substances, and to check haemoglobin levels, blood group, as well as liver and kidney function.
• ECG tests
• Chest X-rays
• Blood Tests
• Urine tests
• To detect high levels of minerals and crystals, which cause stone formation. They also test the presence of blood in the urine. Before any procedure, a urine infection must be ruled out.
• CT scans and ultrasounds
• To accurately test for the presence of bladder stones. However, ultrasounds cannot detect all types of stones.

This is the procedure of tests to be conducted before the surgery:

• A few days before the surgery, the doctor will require some routine tests.
• One week before the surgery, doctors advise against taking medication like aspirin.
• Hospital check in will be one day before surgery.
• Overnight fasting is a prerequisite.
• Informed consent is required.

Anesthesia will be administered before surgery

• General or spinal anesthesia during transurethral cystolitholapaxy
• General anesthesia during percutaneous cystolitholapaxy.

How is Cystolitholapaxy Surgery Performed?

The cystoscope is introduced into the urinary bladder through two approaches. Based on these methods, cystolitholapaxy can be classified into:

In both methods, once the procedure is complete, the cystoscope is removed and the incisions are closed. A Foley catheter is placed in the urethra and attached to a urinary bag to frequently drain urine from the body.

Transurethral Cystolitholapaxy

In this method, the cystoscope is introduced through the urethra, into the urinary bladder. An instrument that emits laser or ultrasound waves is inserted through the cystoscope and breaks down the stones. Any remaining fragments can be removed through suction and irrigation.

This method is least invasive and is often preferred, as it is performed under spinal anesthesia and does not require surgical incisions. Post-operative pain is lesser, thus making recovery faster.

Percutaneous Cystolitholapaxy

The cystoscope is introduced into the bladder through small incisions made in the urinary bladder and abdomen. Similar to the transurethral procedure, the stones are then broken down and removed.

Due to narrow urethras in young children, the cystoscope cannot pass through. In adults with large bladder stones, where the transurethral procedure may be difficult, this procedure works well. However, the recovery time is longer due to greater postoperative pain.

Risks Associated with Cystolitholapaxy Surger

There are a few risks associated with cystolitholapaxy, including:

• Burning sensation while urinating
• Urinary tract infection (antibiotics are prescribed to prevent infections)
• Urinary bladder perforation
• Bleeding
• Difficulty in passing urine, or frequent urination
• Tissue damage, which can lead to the narrowing of the urethra and consequent scar tissue formation.
• The recurrence of stones or an unsuccessful procedure might require open surgery in the future.
• General complications from the surgery or anesthesia such as deep vein thrombosis.

Recovery After Cystolitholapaxy Surgery

• Daily Activities: Regular walks prevent blood clots from forming in the leg post-surgery. 2-5 days after the surgery, the patient can resume all kinds of sports and vigorous activities. Showers can also be resumed once the catheter is removed.
• Diet: Once at home, no special diet is required post-surgery.
• Work: Within 2-3 days, the patient can return to their work, but heavy lifting or strenuous activities should be avoided for 1-2 weeks after surgery.
• Antibiotics: These are as prescribed by the doctor.
• Catheter: The catheter attached to the urine bag is removed 24-48 hours after the surgery.
• Re-Examination: 4-6 weeks post-surgery, a follow-up appointment is to be scheduled with the doctor.

Follow Up After Cystolitholapaxy

Once the procedure has been completed and the anesthesia wears off, the patient is then shifted to the recovery room. Thereafter, the patient is encouraged to drink lots of fluids.

Antibiotics are prescribed to prevent infections, along with pain relievers in case any postoperative discomfort persists.

If the patient notices blood in their urine post-surgery, it is not a cause for worry. The urine soon becomes clear.

Post-surgery, the patient needs to move around as much as they can. If the patient is doing well, the doctor may permit the patient to be discharged from the hospital on the same day.

Looking after the urine bag and emptying it are some postoperative instructions that will be provided by the doctor.

Frequently Asked Questions

1. Are there any dietary restrictions or recommendations after cystolitholapaxy?

After cystolitholapaxy, there are typically no specific dietary restrictions. However, it is generally recommended to stay hydrated by drinking an adequate amount of water and to maintain a healthy, balanced diet. It is advisable to consult with your healthcare provider for any personalized dietary recommendations based on your specific case.

2. Will there be any visible scars or signs after cystolitholapaxy?

The visibility of scars after cystolitholapaxy can vary depending on the surgical technique used. Minimally invasive approaches, such as laparoscopic or robotic-assisted surgery, often result in smaller incisions and less visible scars.

3. Can cystolitholapaxy be performed on pediatric patients?

Yes, cystolitholapaxy can be performed on pediatric patients. However, the decision to perform the procedure depends on various factors such as the child's age, overall health, size and location of the bladder stones, and the expertise of the pediatric urologist.

4. What is the cost associated with cystolitholapaxy procedure in delhi?

The cost associated with a cystolitholapaxy procedure in Delhi can vary depending on factors such as the hospital, surgeon's fees, anesthesia charges, and any additional services or tests required. It is advisable to contact specific hospitals or healthcare providers in Delhi for accurate and up-to-date information regarding the cost.

5. Can bladder stones recur after cystolitholapaxy?

Yes, bladder stones can recur after cystolitholapaxy, a surgical procedure to remove bladder stones. Recurrence can happen if the underlying causes, such as urinary tract infections or anatomical abnormalities, are not addressed or if new stones form due to ongoing risk factors like diet, hydration, or medication. Regular follow-up and preventive measures are important to minimize the risk of recurrence.