Department of Urology, Medical Park, Hospital Urology Clinic, Tokat/, Turkey.
Niger J Clin Pract. 2023 Aug;26(8):1128-1133. doi: 10.4103/njcp.njcp_9_23.
In our study, we aimed to compare the success and complication rates of percutaneous cystolithotripsy (PCCL), transurethral cystolithotripsy (TUCL), and Ho: YAG laser lithotripsy in the surgery of bladder stones that occurred due to various reasons.
Patients diagnosed with single or multiple bladder stones with long axis larger than 2 cm, resulting for various reasons, were included in ou study. Sizes of the stones, cystolithotripsy and discharge times, catheter removal times, complications observed, and the visual pain scale (VPS) were retrospectively evaluated separately from the surgical techniques implemented for accompanying patients and their data.
TUCL (group 1) was implemented in 40, PCCL (group 2) was implemented in 44, and transurethral Ho: YAG laser lithotripsy (group 3) was implemented in 30 of the 121 patients included in the study. The bladder stone long axe group 1 average was 3,7 cm (2,2-5,3), group 2 average was 3,74 cm (2,1-5,1), and group 3 average was 3,7 cm (2,3-4,7). Urethral stricture evolved in two patients who underwent TUCL. A statistically significant difference was observed on behalf of PCCL in terms of operation time. There was significance in the Ho: YAG laser cystolithotripsy group in comparison with VPS scores. No significant differences were found in terms of age, stone size, urethral catheter removal times, and discharge times. The average follow-up time was 6 months.
Although all three methods were quite successful in bladder stone surgery, average cystolithotripsy times were significantly low in the PCCL technique. Thinking that the most common cause of bladder stone is BPH, it is stated that the suprapubic inserted tube ease the bladder drainage during transurethral resection of the prostate (TUR-P). In this way, the duration of the most common accompanying surgeries is shortened and performed more safely.
在我们的研究中，我们旨在比较经皮膀胱镜碎石术（PCCL）、经尿道膀胱镜碎石术（TUCL）和 Ho：YAG 激光碎石术在治疗因各种原因引起的膀胱结石手术中的成功率和并发症发生率。
我们的研究纳入了因各种原因导致长轴大于 2 厘米的单发或多发膀胱结石患者。分别从手术技术的角度回顾性评估了患者的结石大小、碎石和排出时间、导尿管拔除时间、观察到的并发症以及视觉疼痛量表（VPS）。
121 例患者中，40 例行 TUCL（第 1 组），44 例行 PCCL（第 2 组），30 例行经尿道 Ho：YAG 激光碎石术（第 3 组）。第 1 组膀胱结石长轴平均为 3.7 厘米（2.2-5.3），第 2 组平均为 3.74 厘米（2.1-5.1），第 3 组平均为 3.7 厘米（2.3-4.7）。2 例 TUCL 患者发生尿道狭窄。PCCL 在手术时间方面具有统计学意义上的显著差异。Ho：YAG 激光碎石术组在 VPS 评分方面具有显著意义。在年龄、结石大小、尿道导管拔除时间和出院时间方面无显著差异。平均随访时间为 6 个月。
尽管三种方法在膀胱结石手术中都取得了相当大的成功，但 PCCL 技术的平均碎石时间明显较低。考虑到膀胱结石最常见的原因是 BPH，我们指出耻骨上插入的导管在经尿道前列腺切除术（TUR-P）期间有助于膀胱引流。这样可以缩短最常见伴随手术的持续时间，并更安全地进行。
