Comparison of Percutaneous Cystolithotripsy and Transurethral Cystolithotripsy for Treatment of Medium Size Bladder Stone: A Retrospective Study

Introduction: Vesical calculus accounts for nearly 5% of urinary system calculi and is commonly seen in patients with Bladder Outlet Obstruction (BOO), chronic infection, and neurogenic bladder. Open cystolithotomy is an invasive surgery with a long postoperative period and with a high wound infection rate, so only best recommended for large stones. With recent advancements in endourological instruments, cystolithotripsy either by Percutaneous Cystolithotripsy (PCCL) or Transurethral Cystolithotripsy (TUCL) approach has become a safer treatment for medium size stone (2-4 cm).

Aim: To compare the outcome of PCCL and TUCL for medium size bladder stones in adult patients.

Materials and Methods: This retrospective study was conducted between January 2019 to December 2021 in the Department of Urology, Superspeciality Hospital, Shyam Shah Medical College, Rewa, Madhya Pradesh, India. Group I was PCCL (n=32) and group II was TUCL (n=30). PCCL group was compared with TUCL group II for age, stone size, number of stones, operative time, mean urethral entries, postoperative hospital stays, peri and postoperative complications. Statistical analysis was performed using Chi-square and t-test. Differences were accepted to be statistically significant at p-value ≤0.05.

Results: A total of 168 were treated for bladder stones in the Institute and 62 patients were included in the study. No residual stone was observed in any of the two groups. Complete stone clearance was achieved in both groups of patients. Mean operative time and the number of urethral entries were 46.75±2.45 min and 1.06±0.25 min in the PCCL group, and 59.67±3.84 min and 2.87±0.82 min in the TUCL group (p-value -<0.001).

Conclusion: The PCCL appears to be a better technique and preferable over TUCL in bladder stones of size between 2-4 cm.