Can bladder outflow surgery be safely combined with cystolitholapaxy?
BAUS ePoster online library. Jelley C. 11/10/20; 304216; P8-12
Ms. Clare Jelley
Ms. Clare Jelley
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Abstract
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Can bladder outflow surgery be safely combined with cystolitholapaxy?

Jelley C1, Hutchinson L1, Gray R1
1Wycombe Hospital, United Kingdom

Background:
Two thirds of secondary bladder stones are associated with bladder outflow obstruction. There have been studies suggesting an increased complication rate when combining cystolitholapaxy with bladder outflow surgery. We report a single center experience of cystolitholapaxy over a 4-year period focusing on complication rates, stone recurrence rates and bladder outflow (BOS).

Methods:
97 cystolitholapaxy were performed from 2014 to 2018 in 84 male patients. Data was not included for female patients or those with long term catheters for neuropathic bladders. We collected data retrospectively from electronic records.

Results:
The median stone size was 2cm with 41% of patients having multiple stones. 25% of patients had BOS and cystolitholapaxy. BOS was abandoned in 2 cases due to prostatic bleeding. The complication rate was 15%: 8% in the combined group and 17% in the cystolitholapaxy only group, no Clavien-Dindo grade above II. One patient required readmission for haematuria requiring catheterisation and irrigation. Median operative time was 48 minutes in the combined group and 22 minutes in the cystolitholapaxy group. 12 patients underwent 2 or more cystolitholapaxy procedures with a stone recurrence rate of 14%. 16 patients went on to have BOS with a median time of 8 months to surgery.

Conclusion:
This review suggests no higher complication rate in the simultaneous cystolitholapaxy and BOS group when appropriately selected. Simultaneous surgery is desirable but it may not always be possible and further research is required to determine whether selection criteria can be applied.
Can bladder outflow surgery be safely combined with cystolitholapaxy?

Jelley C1, Hutchinson L1, Gray R1
1Wycombe Hospital, United Kingdom

Background:
Two thirds of secondary bladder stones are associated with bladder outflow obstruction. There have been studies suggesting an increased complication rate when combining cystolitholapaxy with bladder outflow surgery. We report a single center experience of cystolitholapaxy over a 4-year period focusing on complication rates, stone recurrence rates and bladder outflow (BOS).

Methods:
97 cystolitholapaxy were performed from 2014 to 2018 in 84 male patients. Data was not included for female patients or those with long term catheters for neuropathic bladders. We collected data retrospectively from electronic records.

Results:
The median stone size was 2cm with 41% of patients having multiple stones. 25% of patients had BOS and cystolitholapaxy. BOS was abandoned in 2 cases due to prostatic bleeding. The complication rate was 15%: 8% in the combined group and 17% in the cystolitholapaxy only group, no Clavien-Dindo grade above II. One patient required readmission for haematuria requiring catheterisation and irrigation. Median operative time was 48 minutes in the combined group and 22 minutes in the cystolitholapaxy group. 12 patients underwent 2 or more cystolitholapaxy procedures with a stone recurrence rate of 14%. 16 patients went on to have BOS with a median time of 8 months to surgery.

Conclusion:
This review suggests no higher complication rate in the simultaneous cystolitholapaxy and BOS group when appropriately selected. Simultaneous surgery is desirable but it may not always be possible and further research is required to determine whether selection criteria can be applied.
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