surgeon: Amil Kumar, MD
Chronic cystitis is the most common cause of bladder calculi. The most important predisposing factors are urethral srticture, tumors, neurogenic bladder dysfunction, long standing indwelling catheter and tuberculosis. Endoscopy evaluation of the urethra and bladder is always recommended. Cystoscopy may reveal multiple calculi and edema of the mucosa, as shown in this picture.
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This is a 72 year old male who was suffering from urinary retention and recurrent urinary tract - infection. This cystoscopy study that showed an enlarged prostate as well as multiple stones causing his symptoms. |
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Due to the size of the stones, large branched calculi, it was decided to use a piezoelectric shock wave lithotripser to produce stone fragmentation by delivering electromechanical energy at the stone surface. The piezoelectric probe was introduced through the cystoscope. |
note: The cystoscope is a "telescope" that is introduced through the penis to allow visualization of the inside of the bladder.
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Several pulses are needed to desintegrate the targeted calculus and effect discharge of all fragments through the urethra. Currently there are more than 10 second-generation lithotripsers being developed which are in use in research and clinical trials. |