WCE 2019: Outcomes of Patients Who Have Undergone Percutaneous Bladder Stone Removal Using a Laparoscopic Entrapment Bag

Abu Dhabi, United Arab Emirates (UroToday.com) Dr. Blair Gallante outlined their study evaluating percutaneous bladder stone removal using a laparoscopic entrapment bag. This procedure is a minimally invasive alternative to transurethral and open cystolithalopaxy. A urethral catheter is used for the laparoscopic entrapment bag instead of an suprapubic (SP) tube, and a sheath is placed inside the bag as opposed to outside of the bag. They retrospectively compared patients that underwent this procedure with a SP tube placed and a urethral catheter placed.

The steps of the procedure are generally as follows: achieve percutaneous bladder access, dilate the tract to 30F, capture the stones in the entrapment bag. Then exteriorize the bag and use the nephroscope for fragmentation. The bag can then be extracted, followed by SP tube or urethral catheter placement.

Out of 43 patients, all were rendered stone free. This is possible because of the entrapment of the stones, using the bladder as a shell for the bag to sit and “catch” the stones. Patients requiring SPtube had longer procedure times and longer length of stay. Higher rates of recurrent urinary retention, leakage, and prolonged need for catheter drainage were observed in the SP tube group. One ER visit occurred in each group, for acute retention in the SP group and a dislodged catheter in the catheter group. One of the main issues with the aforementioned procedures are complications such as extravesical fluid extravasation, hematuria, or urethral trauma. None of these were observed in either group.

This group demonstrated a safe alternative procedure to transurethral and open cystolithalopaxy, which may potentially be done in the outpatient setting. With this procedure, using a urethral catheter postoperatively leads to fewer complications than SP tube placement.

Presented by: Blair Gallante, MPH, Clinical Research Coordinator, Mount Sinai Health System 

Written by: Rajiv Karani Department of Urology, University of California, Irvine at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates