Do you often get urinary tract infections (UTIs)? Do you feel pain, heaviness, or a constant need to urinate? Maybe you have a little blood in your urine? One reason for this could be stones in your bladder. We call these bladder stones. Even if you feel scared when you hear this name, don't worry. There are now very advanced, easy-to-use, and simple treatments for this. That's what we're going to talk about today.
What is Cystolitholapaxy?
Simply put, this is a surgical procedure that breaks up stones in your bladder into small pieces and removes them without making a large incision . These stones are hard, stone-like structures formed by the accumulation of minerals in your urine.
This procedure is done like this: The surgeon inserts a thin, tube-like instrument called a cystoscope into your bladder through your urethra. It has a camera on the end, so the doctor can see exactly where the stones are inside your bladder. Then, using a laser or ultrasound device, the doctor breaks the stones into small pieces. Finally, the crushed stones are washed out with a solution.
One of the biggest advantages of this is that it is an outpatient procedure that can be done the same day . It is performed either under general anesthesia so that you do not feel any pain, or under local anesthesia to numb only the area.
There are two main methods of this surgery.
There are two main methods of performing cystolitholapaxy. Your doctor will determine the most appropriate method based on your condition.
| Surgical method | Who is doing this and how? |
|---|---|
| Transurethral Cystolitholapaxy | This is the most commonly used method. The doctor inserts a thin camera tube (cystoscope) through your urethra, looks for stones, and uses a laser to break them up and remove them. No external incisions are made anywhere in the body. |
| Percutaneous Suprapubic Cystolitholapaxy | This procedure is usually used on young children (because their urinary tracts are very thin) and adults with very large stones . In this procedure, a very small incision is made in the skin and bladder in the lower abdomen, through which instruments are inserted to remove the stones. |
How do you prepare before surgery?
Your doctor will give you all the instructions you need before the surgery. These may include:
- Tell your doctor about any medications you take daily (including medications for diabetes and blood pressure). You may be asked to stop taking some medications, such as blood thinners, a few days before surgery. Do not stop taking any medications without your doctor's advice.
- When to stop eating and drinking: Usually, you are told not to eat or drink anything after midnight the night before surgery.
- Someone to help you get home: Arrange for someone to drive you home after surgery. Due to the effects of the anesthesia, you will not be able to drive a vehicle on your own for the first 24 hours.
- A clear understanding of the surgery: Be sure to ask questions about what will happen on the day of the surgery and what to expect afterward.
Is the surgery painful?
No. You will not feel any pain during the surgery because you will be given anesthesia. Most of the time, you will be given general anesthesia, which will put you completely to sleep. In some cases, you will be awake, but your lower abdomen will be numbed (local anesthesia), so you will not feel any pain.
What to expect after surgery?
These things are normal to happen in the first two or three days after surgery. Don't worry about them.
- A little blood or small blood clots in the urine.
- Feeling a slight burning or pain when urinating.
- Passage of very small stones with urine.
The most important thing is to clearly ask your doctor about what is normal after surgery and when you should talk to him.
Some people may have a catheter placed in their bladder after surgery. This allows urine to flow through a tube into a bag outside the body until the bladder heals. This may be left in place for a few days, and then the doctor will remove it.
Things to follow at home:
- Drink plenty of water after surgery.Drinking at least 2-3 liters a day will help cleanse the urinary system quickly.
- If you have minor pain, take a painkiller like Paracetamol as directed by your doctor.
- If your doctor prescribes antibiotics to prevent infection, take them for the exact length of time prescribed.
- Rest well for the first day or two.
What are the benefits and risks of this surgery?
The biggest advantage of this is that it is a minimally invasive surgery and the recovery is quick . If bladder stones are left untreated, they can lead to frequent urinary tract infections and, over time, permanent damage to the bladder or kidneys.
Although there are some risks with any surgery, this is generally a very safe procedure. The most common complication is a urinary tract infection (UTI). This can be easily treated with antibiotics. Other complications that can occur very rarely include:
- Excessive bleeding
- Scar tissue formation in the urinary tract
- Stone recurrence (if the underlying cause of stone formation is not treated)
- Reactions to memory-altering drugs
Recovery and seeing the doctor again
Most people recover completely within a week or two . You can eat and drink normally when you get home.
- Exercise: Avoid heavy lifting or strenuous exercise for about two weeks. However, it is good to walk a little and climb stairs. Stop if you feel pain.
- Return to work: Depending on the nature of your job, you may be able to return to work in two to three days.
- Medical check-up: The doctor will ask you to come back in about a week or two for a ``post-operative appointment''. If a urinary catheter was inserted, a separate day will be given for its removal.
- Recheck: Sometimes, you may be asked to have an X-ray or CT scan to see if the stones have completely passed or if they are coming back.
When should you call the doctor immediately?
If you still have the following symptoms a week after surgery, call your doctor immediately or go to the hospital where you received treatment.
- Severe pain when urinating .
- Inability to urinate (urinary retention).
- Dark red blood or large blood clots in the urine (a slight pink tinge is normal in the first few days).
- Severe pain in the lower abdomen or back.
- Fever (over 38.5 Celsius / 101 Fahrenheit).
- Chest pain or difficulty breathingIn case of an emergency, go to the nearest hospital Emergency Department (ETU) immediately.
Take-Home Message
- Cystolitholapaxy is a modern, minimally invasive surgical procedure used to remove bladder stones.
- Here, a thin camera tube is used to crush and wash away the stones, so no large incisions are required.
- It is normal to have a slight blood tinge or burning sensation in your urine for a few days after surgery.
- It usually takes 1-2 weeks to fully recover. It is important to drink plenty of water and rest during this time.
- If you experience symptoms such as severe pain, fever, or urinary retention, see your doctor immediately.
- Always following your doctor's instructions is essential for a speedy recovery.
👩🏽⚕️ Additional questions (FAQs)
💬 What is Joint Pain / Arthralgia?
It's not just a minor ache after lifting a heavy object! 'Joint Pain' is a dull ache/sharp pain in one or more joints, such as your knees, hips, shoulders, or finger joints, that makes it difficult to climb stairs/hold a cup, and sometimes causes the joints to become red and swollen. This is not just a normal part of aging, but it can also be a sign of a deadly autoimmune disease!
💬 What are the main reasons for joint pain that makes it impossible to get out of bed?
There are 4 main reasons for this! 1) 'Osteoarthritis' - As we age and in obese people, the cartilage wears down and the bones rub together (knees/hips), causing pain. 2) 'Rheumatoid Arthritis/RA' - Our immune system goes crazy and attacks and destroys our own joints (especially the little fingers of the hand) (in this case, we can't move in the morning, we get stones). 3) Dengue/viral fever. 4) Gout (Gout - Increased uric acid in the blood).
💬 When your joints hurt, you should go to the hospital immediately, without just taking balm/Penadol. What are the 'fatal/emergency cases (Septic Arthritis)'?
For normal wear and tear, you can put a pillow/ice and take a painkiller. But the biggest and most serious danger! If your 'one joint (e.g. knee) suddenly (within a few hours) swells like a balloon, becomes dark red, becomes hot like fire and is unbearable (Severe sudden pain/Warmth) with high fever and shivering', it is definitely a bacteria (Septic Arthritis) that has gone into the joint! If it is even a day late, that joint will rot and become permanently paralyzed, you need to be hospitalized immediately!
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