Cystolitholapaxy is a minimally invasive surgical procedure used to remove bladder stones. Bladder stones are hard mineral deposits that form inside the bladder and can cause pain, infection, and difficulty passing urine.
During the procedure, a surgeon inserts a thin instrument called a cystoscope through the urethra into the bladder. The cystoscope has a small camera that helps the surgeon locate the stones. A laser or special device is then used to break the stones into small fragments, which are flushed out or removed from the bladder.
This procedure is usually performed as an outpatient surgery, meaning patients can return home the same day.
Types of Cystolitholapaxy Procedures
1. Transurethral Cystolitholapaxy
This is the most commonly performed method. A cystoscope is inserted through the urethra into the bladder to locate the stones. A laser or ultrasound device breaks the stones into smaller pieces, which are then removed.
2. Percutaneous Suprapubic Cystolitholapaxy
This method is generally used for children or patients with very large bladder stones. A small incision is made in the lower abdomen to access the bladder directly and remove the stones.
Preparation Before the Procedure
Your doctor will provide specific instructions before surgery, which may include:
Stopping certain medications before the procedure
Avoiding food and drinks after midnight the day before surgery
Informing your doctor about all medications you take
Arranging transportation home after surgery
How the Procedure is Performed
Cystolitholapaxy is done using a thin camera tube called a cystoscope. The instrument is gently inserted through the urethra into the bladder to identify the stones.
Once the stones are located, a laser or energy device is used to break them into small fragments. These fragments are then removed or washed out using sterile fluid.
The procedure usually takes about 30 to 60 minutes.
Anesthesia During Surgery
Patients may receive either:
General anesthesia, where you are completely asleep
Local or regional anesthesia, where you remain awake but do not feel pain in the treated area
Your doctor will decide the most suitable option based on your condition.
What to Expect After Surgery
Some mild symptoms are common in the first few days after the procedure, such as:
Slight blood in the urine
Passing small stone fragments
Burning sensation during urination
These symptoms usually improve within a few days.
In some cases, a temporary catheter may be placed in the bladder to help drain urine while the bladder heals. This is usually removed within a few days to a week.
Post-Procedure Care
After the procedure, patients are usually advised to:
Drink plenty of fluids
Take prescribed pain relief medications if needed
Complete any prescribed antibiotics
Rest for 24–48 hours
Avoid alcohol, driving, or heavy activities during the first day after anesthesia
Benefits of Cystolitholapaxy
Minimally invasive procedure
Short hospital stay
Quick recovery
Effective removal of bladder stones
Helps prevent recurrent urinary infections and bladder damage
Possible Risks and Complications
Cystolitholapaxy is generally safe, but like any surgery, some complications may occur, including:
Urinary tract infection (UTI)
Bleeding
Scar tissue formation in the urethra
Recurrence of bladder stones
Rare reactions to anesthesia
Recovery After Cystolitholapaxy
Most patients recover completely within one to two weeks.
During recovery, doctors may advise:
Avoid heavy lifting for two weeks
Limit strenuous physical activity
Walk regularly to prevent blood clots
Resume normal diet and daily activities gradually
Follow-Up Care
A follow-up visit is usually scheduled 1–2 weeks after surgery. If a catheter was placed, it will be removed during this visit.
Your doctor may also recommend imaging tests such as X-ray or CT scan to ensure all stones are removed and to check for recurrence.
When to Contact Your Doctor
Contact your healthcare provider if you experience:
Severe pain while urinating
Difficulty passing urine
Persistent blood in urine after several days
Fever above 38.5°C (101°F)
Severe abdominal or back pain
Chest pain or breathing difficulty
Difference Between Cystoscopy and Cystolitholapaxy
Sometimes cystoscopy is performed first to diagnose the problem, followed by cystolitholapaxy to treat it.
