The management of vesical calculi with combined optical mechanical cystolithotripsy and transurethral prostatectomy: is it safe and effective?

Abstract

Objectives. To investigate the effectiveness and reliability of the combination of optical mechanical cystolithotripsy (OMC) and transurethral prostatectomy (TURP) for the treatment of bladder calculi and obstructive benign prostatic enlargement (BPE). Patients and methods. From December 1990 to December 1996, 61 patients who had bladder stones and BPE or bladder neck contracture were treated with combined OMC and TURF: 32 patients who had bladder stones with no infravesical obstruction were treated with OMC alone. The records of a random selection of 97 patients with obstructive BPE who were treated with TURF only in the same period were used as the control. The operative duration lime, the length of hospital stay. the duration of urethral catheterization, outcome and complications of the procedures for each patients were reviewed. The Mann-Whitney U-test and chi-square tests were used for statistical analysis. Results. The mean duration of surgery, hospital stay and urethral catheterization were significantly longer with combined OMC and TURF than with OMC alone (P < 0.05). Stone-free rates were 94% after OMC alone and 93% after combined OMC and TURP. The postoperative mean peak flow rates were 14.3 mL/s after the combined procedure and 15.2 mL/s after TURF alone. The complication rates were 21% for the combined procedure and 13% for OMC alone. The complication rate of TURP was 5%, significantly lower than that for the combined procedure (P < 0.05). Conclusion. Bladder stones were associated with infravesical obstruction in two-thirds of patients. Simultaneous treatment with OMC and TURF did not change the effectiveness of these procedures, but caused additional morbidity.