Transurethral cystolithotripsy with a ureteroscope under local urethral anaesthesia and sedoanalgesia. | [Journal of Pakistan Medical Association • 2013]

Author(s):

1. Hakki Uzun: Department of Urology, Istanbul, Turkey

2. Yakup Tomak: Department of Anaesthesiology, Rize University School of Medicine, Rize, Turkey

3. Orhan Ünal Zorba: Department of Anaesthesiology, Rize University School of Medicine, Rize, Turkey

4. Habip Bostan: Department of Anaesthesiology, Rize University School of Medicine, Rize, Turkey

5. Mehmet Kalkan: Department of Urology, Fatih University Sema School of Medicine, Istanbul, Turkey

Abstract:

Objective: To investigate if transurethral cystolithotripsy with a ureteroscope is feasible under local urethral anaesthesia, intravenous sedation and analgesia (sedoanalgesia). Methods: The prospective study was conducted from December 2009 to October 2010 and comprised 18 male patients with bladder calculi over 10mm in widest diameter regardless of etiology. The patients underwent transurethral holmium laser cystolithotripsy with a 9.5f semi-rigid ureteroscope. All patients received 2% idocaine gel local urethral anaesthesia, intravenous 0.03mg/kg midazolam and 7μg/kg alfentanil before the start of lithotripsy. Patients were discharged 1-3 hours after removal of the urethral foley catheter. Patients were asked to scale the discomfort and/or pain level by using visual analogue pain scale. Patients were followed up for at least 6 months. Results: The overall success rate was 89% (n=16). The mean stone diameter and total number of stones in the 16 patients was 21,48 ±6.7 (12-35) mm and 21 stones, respectively. The average age of the 16 patients was 52.3±17.6 (45-78) years and mean operative time from begining of intravenous sedoanalgesia until urethral foley catheter insertion was 19.2±18.9 (4-60) minutes. Mean pain score of the 16 patients after ureteroscopic cystolithotripsy was 1.75±0.6cm (1-6 ). No anaesthesia-related serious complications occurred. After a follow-up of 18 months, recurrent stone formation and urethral stricture was not located in any patient. Conclusions: Transurethral cystolithotripsy with a ureteroscope under local urethral anaesthesia and sedoanalgesia for stones less than 30mm might offer patients safer anaesthesia and shorter operative time with favourable results.

Page(s): 961-964

DOI: DOI not available

Published: Journal: Journal of Pakistan Medical Association, Volume: 63, Issue: 8, Year: 2013

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