14F Super-Mini Percutaneous Cystolitholapaxy: A Novel Technique in the Treatment of Bladder Stones.

This single-center experience describes the indications, novel technique, and outcomes of performing 14F super-mini percutaneous cystolitholapaxy (14F-SMPCCL). Cases between 2019 and 2022 were retrospectively identified with surgical outcomes recorded. Using percutaneous access to the bladder, an endoscope was inserted through the ClearPetra 14F super-mini sheath and laser lithotripsy completed with stone fragments suctioned out. Sixteen cases were included in the study and all patients were adults. Average conglomerate stone size was 28.1 mm (range = 10-50 mm). Average operative time was 60.0 minutes (range = 23-110 minutes). Visual stone-free rate was 91.7%, radiologic stone-free rate was 81.3%, and average postoperative length of stay was 1 day. One patient developed urosepsis postoperatively and there were no other complications. The novel technique of 14F-SMPCCL is safe and feasible for treating large burdens of bladder stones with a conglomerate size of ∼2.5 to 5 cm. Active suction allows for efficient removal of stone fragments.