Management of bladder stones: the move towards non-invasive treatment
Abstract: Bladder stone
accounts for 5% of all cases of urolithiasis. Bladder stones management has evolved
over the last decades from open bladder surgery (sectio alta) to intracorporeal
cystholithotripsy as well as extracorporeal shock wave lithotripsy (ESWL). ESWL
presents to be a promising modality in the management of bladder calculi due to
its simplicity and well tolerability. This study is thus conducted to present
data on the safety and effectiveness of ESWL in the management of bladder stone
patients.
Methods: This is a retrospective study evaluating the medical records of
92 bladder calculi patients admitted to Cipto Mangunkusumo General Hospital
(RSCM) from January 2011 to April 2015. Patient’s age, gender, type of stone
and procedure being done, status of stone disintegration, length of hospital
stay, and any complications that may occur are noted down and statistically
analyzed using SPSS v. 20.
Results: Majority of the patients underwent ESWL (49 out of 92, 53.3%).
The stone free rates for ESWL, intracorporeal lithotripsy, and sectio alta are
93.9%, 97.0% and 100% respectively. One patient had to repeat ESWL. The ESWL
group had the smallest stone size average compared to the intracorporeal
lithotripsy and section alta group (2.5 cm±2.0 cm vs 4.8 cm±3.7 cm vs 7.4
cm±5.4 cm respectively). The ESWL sessions were conducted in the outpatient
clinic, and thus no hospital stay was required.
Conclusion: ESWL can be suggested as an effective non-invasive approach
in the disintegration of bladder stone of ≤25 mm with a promisingly high
stone-free rate (93.9%) Furthermore, ESWL can be performed on an outpatient
basis with minimal complications.
Keywords: Bladder stone;
cystholithotripsy; ESWL; sectio alta
Author: Isaac A. Deswanto, Ari
Basukarno, Ponco Birowo, Nur Rasyid
Journal Code: jpkedokterangg170212
