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Cystolithotomy (Open Removal of Bladder Stones)

Why cystolithotomy?

Most bladder stones can be dealt with by an endoscopic (telescope) procedure, to avoid the need for a surgical incision. If stones are very large, it is often best to perform an open operation. These options will be discussed with you before surgery.

Stones form in the bladder for a variety of reasons. In men, the most common cause is bladder outflow obstruction from an enlarged prostate.

How is the operation done?

Open removal of bladder stones is performed under general anaesthetic as an inpatient procedure. The first step is a cystoscopy. Once the bladder has been examined, an incision is made in the lower abdomen to access the bladder. The bladder is opened and the stone removed.

The bladder is repaired with an absorbable stitch, and a catheter is inserted into the bladder via the urethra. Sometimes it is necessary to gently drip fluid in and out of the bladder for a period of time, as there is often some bleeding from the bladder as a result of the operation.

After the operation

Most patients will stay in for a few nights after the operation. The catheter will remain in place for 7-14 days, depending on the size of the incision in the bladder. You will be discharged when fit, and will be advised to rest at home until you come back in for removal of the catheter. Specific advice will be given on discharge.

Potential side effects and complications

All procedures have the potential for side effects. Although these complications are well recognised, the majority of patients do not have problems after a procedure.

There are specific risks with this surgical procedure, and these will be discussed with you before your procedure. As a guide to complement that one-on-one discussion with your surgeon, these include:

Common

  • A burning sensation and/or a small amount of blood in the urine for a short period afterwards

Occasional

  • Infection of the bladder requiring antibiotics
  • The need for a longer period with the catheter
  • Infection in the surgical incision

Rare

  • Temporary insertion of a new catheter if you are unable to pass urine immediately after the first one is removed
  • Delayed bleeding requiring removal of clots or further surgery
  • Injury to the urethra causing delayed scar formation
  • Fever and more serious infection requiring a longer hospital stay
  • Delayed healing of the bladder, or a leak from the bladder which requires a further procedure or a prolonged period with a catheter

If you develop a fever, severe pain on passing urine, inability to pass urine or worsening bleeding, you should contact the practice immediately. If out of hours, please go to your nearest emergency department.


Disclaimer

This information is intended as an educational guide only, and is here to help you as an additional source of information, along with a consultation from your urologist. The information does not apply to all patients.

Not all potential complications are listed, and you must talk to your urologist about the complications specific to your situation.

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