Cystolitholapaxy — Bladder Stone Removal

What is this procedure?

Cystolitholapaxy is an endoscopic operation to break up and remove stones that have formed inside the bladder. A telescope is passed through the urethra into the bladder — no cuts are made in the skin. Depending on the size and hardness of the stone, a laser or mechanical lithotripter is used to fragment it into small pieces, which are then washed out of the bladder. The procedure is usually performed as a day case under general or spinal anaesthesia. If an underlying cause such as bladder outlet obstruction is found, additional treatment (for example TURBT for a small lesion, or a plan for prostate surgery) may be recommended.

Before your procedure

• Fasting: Do not eat or drink for six hours before your admission time.
• Urine infection: An active urinary infection must be treated before proceeding. Inform the team if you have had urinary symptoms recently.
• Medications: Blood-thinning medications must be paused according to the specific instructions provided — do not stop them independently.
• What to bring: Photo ID, insurance documents, medication list, and comfortable loose clothing for going home.

What happens during the procedure

Under anaesthesia, the telescope is passed through the urethra into the bladder. The stone is identified and fragmented using the chosen energy source (laser or ultrasonic/mechanical probe). The fragments are washed out through the telescope sheath. The bladder lining and outlet are inspected carefully for any associated abnormality. A urinary catheter is placed at the end of the procedure. The operation typically takes 20–60 minutes.

After the procedure and recovery

• Catheter: A catheter is usually in place for a short period — often removed on the same day or the morning after surgery.
• Hospital stay: Most patients are discharged the same day or after one night.
• Haematuria: Some pink or blood-stained urine is normal for a few days. Drink 2–3 litres of fluid daily to keep the urine clear.
• Driving: Do not drive for 24 hours after a general anaesthetic and not until you are comfortable and can perform an emergency stop.
• Return to work: Light desk-based work can usually resume within a few days; avoid heavy physical work for one to two weeks.
• Preventing recurrence: Stone formation can recur. Dr Hadjipavlou may request a stone analysis and blood/urine tests to investigate the underlying cause and recommend dietary or medical measures to reduce the risk.

When to seek medical help

Contact the secretary on 22 444 444 or El Greco Medical Centre +357 22 782 000 out of hours if you experience:

• Fever above 38 °C, shivering, or rigors
• Inability to pass urine after catheter removal
• Heavy bright-red bleeding or large clots
• Severe pain not controlled by prescribed analgesia

Attend the nearest Accident & Emergency department if you feel acutely unwell or cannot reach us.