Emerging Role of Laser Lithotripsy for Bladder Stones: Real-World Outcomes from Two European Endourology Centers with a Systematic Review of Literature.

IF 2.9 2区 医学 Q1 UROLOGY & NEPHROLOGY
Journal of endourology Pub Date : 2025-03-01 Epub Date: 2025-02-05 DOI:10.1089/end.2024.0640
Clara Cerrato, Maria Florencia Frascheri, Shriya Napoleon Fernandez, Esteban Emiliani, Paola Arena, Amelia Pietropaolo, Bhaskar K Somani
{"title":"Emerging Role of Laser Lithotripsy for Bladder Stones: Real-World Outcomes from Two European Endourology Centers with a Systematic Review of Literature.","authors":"Clara Cerrato, Maria Florencia Frascheri, Shriya Napoleon Fernandez, Esteban Emiliani, Paola Arena, Amelia Pietropaolo, Bhaskar K Somani","doi":"10.1089/end.2024.0640","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Introduction and Objective:</i></b> We aimed to look at the evidence for laser lithotripsy for bladder stones (BSs) to provide results from two centers on bladder calculi treatment. In addition, the outcomes of prostatic and other surgical interventions performed in nearly half of all patients. <b><i>Methods:</i></b> A retrospective analysis of two large European endourology tertiary centers for patients who underwent laser lithotripsy for BS between 2016 and 2024 (7 years). All patients provided consent and were counseled for the study accordingly, and the studies were registered as an audit in the individual centers. <b><i>Results:</i></b> A total of 122 patients were analyzed (mean age of 68.17 ±16.38 years; male:female ratio of 97:25). Thirteen (10.7%) patients had a preoperative long-term catheter. Overall, 42 (34.43%) patients had multiple stones (<i>n</i> = 2.19, ±2.08), with a median stone burden of 32.36 ± 24.13 mm. The mean operative time was 61.6 ± 37.25 minutes, with an overall stone-free rate (SFR) of 95.1% (<i>n</i> = 116). Postoperative complications were noted in nine (7.38%) patients, which included urinary tract infection or sepsis (<i>n</i> = 4, 3%), pain (<i>n</i> = 2, 1.6%), and bleeding/acute urinary retention/urethral stone (<i>n</i> = 1 each, 0.82%). All the complications were Clavien-Dindo I/II and treated conservatively. Six patients (4.9%) with planned concomitant surgical intervention needed a completion (second) intervention at a later date. Sixty patients (49.2%) had concomitant procedure along with their BS treatment. Twenty-two patients (18%) with a mean prostate size of 60.71 cc (±30.50 cc) underwent a transurethral resection of prostate (<i>n</i> = 16, 13.1%) or bladder neck incision (<i>n</i> = 6, 4.9%). Others underwent ureteroscopy (<i>n</i> = 13, 10.7%), transurethral resection of bladder tumor (<i>n</i> = 5, 4.1%), suprapubic catheter repositioning (<i>n</i> = 10, 8.2%), or urethral dilation (<i>n</i> = 10, 8.2%). The mean hospital stay was 1.4 ± 1.33 days. <b><i>Conclusion:</i></b> Laser fragmentation of BSs stands out as a safe and efficient choice with a good SFR and low risk of major complications, and perhaps should be considered the new gold standard for BS management. It also allows for concomitant treatment of enlarged prostate and other endourologic procedures with good outcomes.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"285-291"},"PeriodicalIF":2.9000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of endourology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/end.2024.0640","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/5 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction and Objective: We aimed to look at the evidence for laser lithotripsy for bladder stones (BSs) to provide results from two centers on bladder calculi treatment. In addition, the outcomes of prostatic and other surgical interventions performed in nearly half of all patients. Methods: A retrospective analysis of two large European endourology tertiary centers for patients who underwent laser lithotripsy for BS between 2016 and 2024 (7 years). All patients provided consent and were counseled for the study accordingly, and the studies were registered as an audit in the individual centers. Results: A total of 122 patients were analyzed (mean age of 68.17 ±16.38 years; male:female ratio of 97:25). Thirteen (10.7%) patients had a preoperative long-term catheter. Overall, 42 (34.43%) patients had multiple stones (n = 2.19, ±2.08), with a median stone burden of 32.36 ± 24.13 mm. The mean operative time was 61.6 ± 37.25 minutes, with an overall stone-free rate (SFR) of 95.1% (n = 116). Postoperative complications were noted in nine (7.38%) patients, which included urinary tract infection or sepsis (n = 4, 3%), pain (n = 2, 1.6%), and bleeding/acute urinary retention/urethral stone (n = 1 each, 0.82%). All the complications were Clavien-Dindo I/II and treated conservatively. Six patients (4.9%) with planned concomitant surgical intervention needed a completion (second) intervention at a later date. Sixty patients (49.2%) had concomitant procedure along with their BS treatment. Twenty-two patients (18%) with a mean prostate size of 60.71 cc (±30.50 cc) underwent a transurethral resection of prostate (n = 16, 13.1%) or bladder neck incision (n = 6, 4.9%). Others underwent ureteroscopy (n = 13, 10.7%), transurethral resection of bladder tumor (n = 5, 4.1%), suprapubic catheter repositioning (n = 10, 8.2%), or urethral dilation (n = 10, 8.2%). The mean hospital stay was 1.4 ± 1.33 days. Conclusion: Laser fragmentation of BSs stands out as a safe and efficient choice with a good SFR and low risk of major complications, and perhaps should be considered the new gold standard for BS management. It also allows for concomitant treatment of enlarged prostate and other endourologic procedures with good outcomes.

激光碎石术在膀胱结石治疗中的新作用:来自两个欧洲泌尿系统中心的真实世界结果与文献系统综述。
简介与目的:我们旨在探讨激光碎石治疗膀胱结石(BSs)的证据,以提供两个中心膀胱结石治疗的结果。此外,前列腺和其他手术干预的结果在所有患者中占近一半。方法:回顾性分析2016年至2024年(7年)欧洲两家大型泌尿系统三级中心接受BS激光碎石治疗的患者。所有患者都同意并接受相应的研究咨询,研究在各个中心登记为审计。结果:共分析122例患者(平均年龄68.17±16.38岁;男女比例为97:25)。13例(10.7%)患者术前有长期导尿管。总体而言,42例(34.43%)患者有多发结石(n = 2.19,±2.08),中位结石负担为32.36±24.13 mm。平均手术时间为61.6±37.25分钟,总结石清除率(SFR)为95.1% (n = 116)。术后并发症9例(7.38%),包括尿路感染或脓毒症(n = 4, 3%)、疼痛(n = 2, 1.6%)、出血/急性尿潴留/尿道结石(n = 1, 0.82%)。所有并发症均为Clavien-Dindo I/II型,保守治疗。6例(4.9%)计划合并手术干预的患者需要在晚些时候完成(第二次)干预。60例患者(49.2%)在BS治疗的同时进行了手术。22例(18%)患者平均前列腺大小为60.71 cc(±30.50 cc),行经尿道前列腺切除术(n = 16, 13.1%)或膀胱颈切开(n = 6, 4.9%)。其他患者接受输尿管镜检查(n = 13, 10.7%)、经尿道膀胱肿瘤切除术(n = 5, 4.1%)、耻骨上导管重新定位(n = 10, 8.2%)或尿道扩张(n = 10, 8.2%)。平均住院时间1.4±1.33天。结论:激光碎裂是一种安全有效的选择,具有良好的SFR和较低的主要并发症风险,可能应被视为BS治疗的新金标准。它也允许同时治疗前列腺肥大和其他泌尿系统手术,效果良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of endourology
Journal of endourology 医学-泌尿学与肾脏学
CiteScore
5.50
自引率
14.80%
发文量
254
审稿时长
1 months
期刊介绍: Journal of Endourology, JE Case Reports, and Videourology are the leading peer-reviewed journal, case reports publication, and innovative videojournal companion covering all aspects of minimally invasive urology research, applications, and clinical outcomes. The leading journal of minimally invasive urology for over 30 years, Journal of Endourology is the essential publication for practicing surgeons who want to keep up with the latest surgical technologies in endoscopic, laparoscopic, robotic, and image-guided procedures as they apply to benign and malignant diseases of the genitourinary tract. This flagship journal includes the companion videojournal Videourology™ with every subscription. While Journal of Endourology remains focused on publishing rigorously peer reviewed articles, Videourology accepts original videos containing material that has not been reported elsewhere, except in the form of an abstract or a conference presentation. Journal of Endourology coverage includes: The latest laparoscopic, robotic, endoscopic, and image-guided techniques for treating both benign and malignant conditions Pioneering research articles Controversial cases in endourology Techniques in endourology with accompanying videos Reviews and epochs in endourology Endourology survey section of endourology relevant manuscripts published in other journals.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信