Endoscopic Management of Bladder Stones: Initial Experience at a Single Center in Cameroon

Abstract

Purpose: This study aimed to evaluate the efficacy and safety of endoscopic lithotripsy with the lithoclast (EMS, Switzerland) and laser Holmium YAG in the management of bladder calculi. Materials and methods: This was a retrospective study carried out from January 2013 to December 2019 on 32 patients with bladder calculi. All the patients underwent either Lithoclast or Laser lithotripsy using a 22F Storz cystoscope at the Centre medico-chirugicale d’urologi e in Douala, Cameroon. Data on patients’ ages, clinical symptoms, stone sizes, type of lithotripsy, surgery duration, and results of lithotripsy were collected and analyzed using Epi info 7. Results: We recruited 32 participants (24 men and 8 women) with a median age of 41.28 [22 - 68] years into this study. In 9 (28.12%) participants, macroscopic hematuria was the main presenting complaint, followed by lower urinary tract symptoms in 8 (25%) patients. A cystoscopy was performed in 17 (53.12%) patients to confirm the diagnosis of a bladder stone, and ultrasonography of the upper urinary tract was performed in 29 (90.6%) cases to certify the absence of another stone. Lithoclast EMS was used to manage the stones in 23 (71.87%) patients while laser lithotripsy was used in 9 (28.13%). A dormia basket was used to remove stone fragments in 10 (31.25%) patients. The mean surgery duration was 33.59 ± 14.2 minutes, and the bladder stones were successfully managed in all the participants of this study. Minor complications such as pain during micturition were found in 28 (87.37%) patients, with complete resolution occurring two weeks after surgery. Conclusion: Endoscopy with lithotripsy is a safe and effective method of management of bladder stones. This technique is also associated with short surgical procedures and postoperative hospitalization periods. We believe that it is an excellent treatment modality in the management of bladder stones.