Abstract:

Objective: We aimed to evaluate the efficacy and safety of Holmium: YAG Laser Cystolithotripsy HLS procedures performed for bladder stones >20 mm in the same session with bipolar transurethral prostate resection Plasmakinetic Transurethral Prostate Resection PK-TURP . Material and Methods: Files of thirty-three patients underwent HLS for large bladder stones >20 mm and PK-TURP for Benign Prostatic Obstruction BPO in the same session in our clinic between January 2012 and July 2013 were analyzed retrospectively. Patient demographics, IPSS, Qmax, PVR, prostate volume, stone size, operative time, perioperative complications, length of hospital stay, were evaluated. Results: The mean patient age was 67,54±10,52 45-84 years. The mean stone size, preoperative prostate volume, fragmentation duration, all operation duration and length of hospital stay were 31,39±8,91 20-60 mm, 65,45±12,7 45-94 cc, 40,48±13,6 20-90 minutes, 109,39±19,75 65-150 minutes and 3,56±1,14 2-7 days, respectively. No major intraoperative complications occurred. After a mean follow-up of 6 months, no recurrent stones were recorded. No patients required blood transfusions nor developed blood clot retentions. The most common complication after surgery was transient stress urinary incontinence in two patients. One patient needed another surgical intervention for a residual stone post operatively. Three patients developed urinary tract infection and bulbar urethral strictures developed in four patients after six months post operatively. Three of them also had intraoperative bladder mucosal injury. Complications were graded using modified Clavien grading system. Post operative third month life quality was found to be statistically better than preoperative quality of life p20 mm in the same session with PK-TURP for BPO

Keywords: