Bladder Stone Removal (Cystolitholapaxy)
What is Bladder Stone Removal (Cystolitholapaxy)?
Cystolitholapaxy is a minimally invasive procedure used to remove stones that have formed inside the bladder. Bladder stones develop when minerals in urine crystallise and harden, often because the bladder does not empty completely. They can cause pain, frequent urination, blood in the urine, recurrent urinary tract infections, and difficulty passing urine.
During cystolitholapaxy, a small camera is inserted through the urethra into the bladder, and specialised instruments or laser technology are used to break the stones into small fragments that can be removed. The procedure avoids the need for a large surgical incision in most patients.
What are the Benefits of Bladder Stone Removal (Cystolitholapaxy)?
Cystolitholapaxy is an effective treatment that relieves symptoms while minimising recovery time.
Benefits include:
- Removes bladder stones without open surgery
- Relieves pain and urinary symptoms
- Reduces the risk of recurrent urinary tract infections
- Improves bladder emptying
- Minimally invasive with no external incision
- Short hospital stay or day-case treatment for many patients
- Quick return to normal activities
- Can be combined with treatment for the underlying cause of bladder stones when appropriate
When is Bladder Stone Removal (Cystolitholapaxy) Recommended?
Your urologist may recommend cystolitholapaxy if bladder stones are causing symptoms or complications.
Common reasons for treatment include:
- Pain or discomfort caused by bladder stones
- Blood in the urine (haematuria)
- Frequent urinary tract infections
- Difficulty passing urine
- Interrupted urinary stream
- Bladder outlet obstruction caused by an enlarged prostate
- Stones identified during investigation of urinary symptoms
- Large bladder stones unlikely to pass naturally
Your urologist will also investigate the underlying cause of the stones to help reduce the risk of recurrence.
What does Preparation for Bladder Stone Removal (Cystolitholapaxy) Involve?
Before the procedure, your healthcare team will assess your general health and the size and location of the bladder stones.
Preparation may include:
- Medical history and physical examination
- Urine testing to exclude infection
- Blood tests
- Imaging such as ultrasound, CT scan, or X-ray
- Review of medications, including blood-thinning medicines
- Fasting before general or spinal anaesthetic
- Antibiotics if an infection is present or to reduce the risk of infection
- Discussion of the procedure, expected recovery, and possible risks
You will also receive instructions regarding your admission and discharge arrangements.
How is Bladder Stone Removal (Cystolitholapaxy) Performed?
Cystolitholapaxy is usually performed under general or spinal anaesthetic and typically takes between 30 and 90 minutes, depending on the size and number of stones.
A thin telescope called a cystoscope is passed through the urethra into the bladder. Because the procedure uses the natural urinary passage, no external incision is required. The surgeon examines the bladder and identifies the stones.
Specialised instruments are then used to break the stones into smaller pieces. This may be achieved using laser energy, ultrasonic technology, pneumatic devices, or mechanical crushing instruments, depending on the size and composition of the stones. Once fragmented, the pieces are flushed out or removed using tiny grasping instruments.
At the end of the procedure, the bladder is carefully inspected to ensure that as many stone fragments as possible have been removed. In some patients, a temporary urinary catheter is inserted to allow the bladder to drain while the lining heals.
If bladder stones are caused by an enlarged prostate or another obstructive condition, additional treatment may be recommended either during the same operation or at a later date.
What to Expect during Recovery after Bladder Stone Removal (Cystolitholapaxy)?
Most patients recover quickly and return home the same day or after an overnight stay.
During recovery, it is common to experience:
- Mild burning or discomfort when passing urine
- Blood in the urine for several days
- Increased urinary frequency or urgency
- Temporary bladder irritation
- Mild pelvic discomfort
Drinking plenty of fluids helps flush the bladder and reduce irritation. Most patients can resume light daily activities within a few days, although strenuous exercise and heavy lifting should be avoided until advised by your surgeon.
A follow-up appointment may be arranged to review recovery and investigate any underlying cause of bladder stone formation.
What are the Risks and Complications of Bladder Stone Removal (Cystolitholapaxy)?
Cystolitholapaxy is a safe and commonly performed procedure, but all surgical treatments carry some potential risks.
Possible complications include:
- Urinary tract infection
- Temporary blood in the urine
- Burning during urination
- Bladder irritation causing urgency or frequency
- Difficulty passing urine requiring temporary catheterisation
- Injury to the bladder or urethra
- Retained stone fragments requiring additional treatment
- Recurrence of bladder stones if the underlying cause is not addressed
- Rare narrowing of the urethra (urethral stricture)
Your urologist will explain why cystolitholapaxy is recommended, discuss the potential risks and benefits, and advise on strategies to reduce the likelihood of future bladder stone formation.