Percutaneous or Transurethral Cystolithotomy for Bladder Lithiasis: Which is Safer?
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.24915/aup.36.1-2.115 |
Resumo: | Introduction: Although the risk of urethral trauma while treating bladder stones is worrisome, evidence about the best treatment approach is scarce. The aim of this study is to compare the safety and efficacy of transurethral cystolithotomy and percutaneous suprapubic cystolithotomy in adults´ bladder lithiasis treatment. Methods: We retrospectively evaluated 120 patients (January 2012 to December 2017) who were surgically treated for bladder lithiasis with percutaneous suprapubic cystolithotomy (n= 20) and transurethral cystolithotomy (n= 100). Age, gender, calculi size, surgery duration, hospital stay, post-operative infections, haematuria, pain and urethral strictures were evaluated. Previous diagnosis of benign prostate hyperplasia and urethral strictures were also considered. Results: Both groups were homogeneous according to the pre-operative variables evaluated, including calculi dimensions and simultaneous diagnosis. Median surgery time in percutaneous suprapubic cystolithotomy and transurethral cystolithotomy were 65 and 58 minutes, respectively (p= 0.043). Pain and haematuria were similar in both groups. Median hospital stay was 2.0 days in both groups. Median follow-up time was 13 months. In the transurethral cystolithotomy, three patients (3%) developed urethral stricture while none of the patients treated with PSC developed urethral strictures during the follow-up (p= 0.435). Discussion: Percutaneous suprapubic cystolithotomy theoretically offers an advantage over transurethral cystolithotomy in terms of urethral trauma, although we did not observe a significant difference. However, it deserves to be considered, especially in patients with known urethral strictures that may hinder transurethral access. Further prospective studies with more patients may however confirm these theoretical advantages. |
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Percutaneous or Transurethral Cystolithotomy for Bladder Lithiasis: Which is Safer?Cistolitotomia Percutânea ou Transuretral: Qual é Mais Segura?Lithotripsy/methodsTreatment OutcomeUrinary Bladder Calculi/surgeryUrinary Bladder Calculi/therapyCálculos da Bexiga Urinária/cirurgiaCálculos da Bexiga Urinária/tratamentoLitotrícia/métodosResultado do TratamentoIntroduction: Although the risk of urethral trauma while treating bladder stones is worrisome, evidence about the best treatment approach is scarce. The aim of this study is to compare the safety and efficacy of transurethral cystolithotomy and percutaneous suprapubic cystolithotomy in adults´ bladder lithiasis treatment. Methods: We retrospectively evaluated 120 patients (January 2012 to December 2017) who were surgically treated for bladder lithiasis with percutaneous suprapubic cystolithotomy (n= 20) and transurethral cystolithotomy (n= 100). Age, gender, calculi size, surgery duration, hospital stay, post-operative infections, haematuria, pain and urethral strictures were evaluated. Previous diagnosis of benign prostate hyperplasia and urethral strictures were also considered. Results: Both groups were homogeneous according to the pre-operative variables evaluated, including calculi dimensions and simultaneous diagnosis. Median surgery time in percutaneous suprapubic cystolithotomy and transurethral cystolithotomy were 65 and 58 minutes, respectively (p= 0.043). Pain and haematuria were similar in both groups. Median hospital stay was 2.0 days in both groups. Median follow-up time was 13 months. In the transurethral cystolithotomy, three patients (3%) developed urethral stricture while none of the patients treated with PSC developed urethral strictures during the follow-up (p= 0.435). Discussion: Percutaneous suprapubic cystolithotomy theoretically offers an advantage over transurethral cystolithotomy in terms of urethral trauma, although we did not observe a significant difference. However, it deserves to be considered, especially in patients with known urethral strictures that may hinder transurethral access. Further prospective studies with more patients may however confirm these theoretical advantages.Introdução: Apesar do risco de trauma uretral durante o tratamento de litíase vesical ser preocupante, há pouca evidência acerca do melhor método endourológico a usar. O objectivo deste estudo é comparar a segurança e eficácia da cistolitotomia transuretral e da cistolitotomia percutânea suprapúbica no tratamento de litíase vesical de adultos. Métodos: Cento e vinte doentes submetidos a tratamento de litíase vesical entre Janeiro de 2012 e Dezembro de 2017 foram retrospectivamente avaliados. Destes, 20 foram submetidos a cistolitotomia percutânea suprapúbica e 100 a cistolitotomia transuretral. Sexo, idade, volume litiásico, duração da cirurgia, duração da estadia hospitalar e complicações (infecção, hematúria, dor e estenose da uretra) foram avaliados, assim como diagnósticos prévios de hiperplasia benigna da próstata e estenoses uretrais. Resultados: Os grupos analisados não apresentavam diferenças significativas relativamente às variáveis pré-operatórias analisadas, incluindo volume litiásico e diagnósticos prévios. O tempo mediano de cirurgia na cistolitotomia percutânea suprapúbica e cistolitotomia transuretral foi de 68 e 58 minutos, respectivamente (p= 0,043) e o tempo médio de internamento foi de 2 dias em ambos os grupos. O tempo médio de seguimento foi de 13 meses. No grupo cistolitotomia transuretral, três doentes (3%) desenvolveram estenose da uretra pós operatória enquanto nenhum dos doentes no grupo cistolitotomia percutânea suprapúbica teve esta complicação (p= 0,435). A dor e hematúria foram semelhantes em ambos os grupos. Discussão: A cistolitotomia percutânea suprapúbica oferece em teoria uma vantagem sobre a cistolitotomia transuretral em termos de risco de trauma uretral, embora neste estudo não tenha sido confirmada esta vantagem. De qualquer forma, merece ser considerada, principalmente em doentes com história de estenose da uretra que possa dificultar o procedimento transuretral. Estudos futuros prospectivos e com mais doentes são necessários para confirmar esta vantagem.Associação Portuguesa de Urologia2019-09-21T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.24915/aup.36.1-2.115oai:oai.actaurologicaportuguesa.com:article/115Acta Urológica Portuguesa; Vol. 36 No. 1-2 (2019): January - June; 17-22Acta Urológica Portuguesa; v. 36 n. 1-2 (2019): Janeiro - Junho; 17-222387-04192341-4022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://www.actaurologicaportuguesa.com/index.php/aup/article/view/115https://doi.org/10.24915/aup.36.1-2.115http://www.actaurologicaportuguesa.com/index.php/aup/article/view/115/50Copyright (c) 2019 Portuguese Association of Urologyinfo:eu-repo/semantics/openAccessTorres, Joao PimentelFernandes, VítorMorais, NunoAnacleto, SaraMota, PauloLima, Estêvão2022-09-21T09:04:48Zoai:oai.actaurologicaportuguesa.com:article/115Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:55:54.829358Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Percutaneous or Transurethral Cystolithotomy for Bladder Lithiasis: Which is Safer? Cistolitotomia Percutânea ou Transuretral: Qual é Mais Segura? |
title |
Percutaneous or Transurethral Cystolithotomy for Bladder Lithiasis: Which is Safer? |
spellingShingle |
Percutaneous or Transurethral Cystolithotomy for Bladder Lithiasis: Which is Safer? Torres, Joao Pimentel Lithotripsy/methods Treatment Outcome Urinary Bladder Calculi/surgery Urinary Bladder Calculi/therapy Cálculos da Bexiga Urinária/cirurgia Cálculos da Bexiga Urinária/tratamento Litotrícia/métodos Resultado do Tratamento |
title_short |
Percutaneous or Transurethral Cystolithotomy for Bladder Lithiasis: Which is Safer? |
title_full |
Percutaneous or Transurethral Cystolithotomy for Bladder Lithiasis: Which is Safer? |
title_fullStr |
Percutaneous or Transurethral Cystolithotomy for Bladder Lithiasis: Which is Safer? |
title_full_unstemmed |
Percutaneous or Transurethral Cystolithotomy for Bladder Lithiasis: Which is Safer? |
title_sort |
Percutaneous or Transurethral Cystolithotomy for Bladder Lithiasis: Which is Safer? |
author |
Torres, Joao Pimentel |
author_facet |
Torres, Joao Pimentel Fernandes, Vítor Morais, Nuno Anacleto, Sara Mota, Paulo Lima, Estêvão |
author_role |
author |
author2 |
Fernandes, Vítor Morais, Nuno Anacleto, Sara Mota, Paulo Lima, Estêvão |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Torres, Joao Pimentel Fernandes, Vítor Morais, Nuno Anacleto, Sara Mota, Paulo Lima, Estêvão |
dc.subject.por.fl_str_mv |
Lithotripsy/methods Treatment Outcome Urinary Bladder Calculi/surgery Urinary Bladder Calculi/therapy Cálculos da Bexiga Urinária/cirurgia Cálculos da Bexiga Urinária/tratamento Litotrícia/métodos Resultado do Tratamento |
topic |
Lithotripsy/methods Treatment Outcome Urinary Bladder Calculi/surgery Urinary Bladder Calculi/therapy Cálculos da Bexiga Urinária/cirurgia Cálculos da Bexiga Urinária/tratamento Litotrícia/métodos Resultado do Tratamento |
description |
Introduction: Although the risk of urethral trauma while treating bladder stones is worrisome, evidence about the best treatment approach is scarce. The aim of this study is to compare the safety and efficacy of transurethral cystolithotomy and percutaneous suprapubic cystolithotomy in adults´ bladder lithiasis treatment. Methods: We retrospectively evaluated 120 patients (January 2012 to December 2017) who were surgically treated for bladder lithiasis with percutaneous suprapubic cystolithotomy (n= 20) and transurethral cystolithotomy (n= 100). Age, gender, calculi size, surgery duration, hospital stay, post-operative infections, haematuria, pain and urethral strictures were evaluated. Previous diagnosis of benign prostate hyperplasia and urethral strictures were also considered. Results: Both groups were homogeneous according to the pre-operative variables evaluated, including calculi dimensions and simultaneous diagnosis. Median surgery time in percutaneous suprapubic cystolithotomy and transurethral cystolithotomy were 65 and 58 minutes, respectively (p= 0.043). Pain and haematuria were similar in both groups. Median hospital stay was 2.0 days in both groups. Median follow-up time was 13 months. In the transurethral cystolithotomy, three patients (3%) developed urethral stricture while none of the patients treated with PSC developed urethral strictures during the follow-up (p= 0.435). Discussion: Percutaneous suprapubic cystolithotomy theoretically offers an advantage over transurethral cystolithotomy in terms of urethral trauma, although we did not observe a significant difference. However, it deserves to be considered, especially in patients with known urethral strictures that may hinder transurethral access. Further prospective studies with more patients may however confirm these theoretical advantages. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-09-21T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.24915/aup.36.1-2.115 oai:oai.actaurologicaportuguesa.com:article/115 |
url |
https://doi.org/10.24915/aup.36.1-2.115 |
identifier_str_mv |
oai:oai.actaurologicaportuguesa.com:article/115 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://www.actaurologicaportuguesa.com/index.php/aup/article/view/115 https://doi.org/10.24915/aup.36.1-2.115 http://www.actaurologicaportuguesa.com/index.php/aup/article/view/115/50 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2019 Portuguese Association of Urology info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2019 Portuguese Association of Urology |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Associação Portuguesa de Urologia |
publisher.none.fl_str_mv |
Associação Portuguesa de Urologia |
dc.source.none.fl_str_mv |
Acta Urológica Portuguesa; Vol. 36 No. 1-2 (2019): January - June; 17-22 Acta Urológica Portuguesa; v. 36 n. 1-2 (2019): Janeiro - Junho; 17-22 2387-0419 2341-4022 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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