Lee Matthew S, Sledge Trey R, Seyer Amanda K, Qi Robert, Koo Kevin
Department of Urology, Mayo Clinic, Rochester, MN 55905, USA.
Can J Urol. 2025 Aug 29;32(4):325-333. doi: 10.32604/cju.2025.064255.
While cystolitholapaxy for bladder stones is commonly performed using a transurethral approach, large or complex stone burdens in patients with complex lower urinary tract anatomy may make this inefficient or infeasible. Percutaneous cystolitholapaxy is a safe, effective, minimally invasive alternative for diverse indications, including patients with benign prostatic hyperplasia, urethral stricture disease, closed bladder neck, continent catheterized channel, or other urinary diversion. In this article, we review the indications for and advantages of percutaneous cystolitholapaxy and describe our step-by-step technique for this procedure, including representative imaging and favored equipment. We also discuss preoperative and postoperative considerations, management of potential complications, strategies to optimize clinical outcomes and patient safety, and comparisons with transurethral approaches. Finally, we report outcomes from our institutional series of percutaneous cystolitholapaxy cases to highlight the safety and efficacy of the procedure.
虽然膀胱结石的膀胱碎石术通常采用经尿道途径进行，但对于下尿路解剖结构复杂的患者，较大或复杂的结石负荷可能会使这种方法效率低下或不可行。经皮膀胱碎石术是一种安全、有效的微创替代方法，适用于多种适应症，包括良性前列腺增生、尿道狭窄疾病、膀胱颈闭合、可控导尿通道或其他尿流改道的患者。在本文中，我们回顾了经皮膀胱碎石术的适应症和优点，并描述了我们进行该手术的逐步技术，包括代表性影像学检查和常用设备。我们还讨论了术前和术后注意事项、潜在并发症的处理、优化临床结果和患者安全的策略，以及与经尿道方法的比较。最后，我们报告了我们机构经皮膀胱碎石术病例系列的结果，以突出该手术的安全性和有效性。
