Outcome of management of patients with BPH and vesical calculi

Abstract

INTRODUCTION: The complications of benign prostatic hyperplasia (BPH) among others include bladder stones. The prevalence of vesical calculus is eight times higher in men having BPH (3.4%) as compared with men without BPH (0.4%). The guidelines suggest that BPH obstruction should be managed along with removal of bladder stones. The objective of the study was to study the outcome of surgery in patients with BPH and bladder calculi. MATERIALS AND METHODS: This prospective study included all patients undergoing surgical treatment for BPH with vesical calculi. Outcomes were measured in terms of blood loss, operating time, days of hospitalization, postoperative urinary flow, postvoid residual, and complications. RESULTS: Five (13.51%) patients underwent perurethral cystolitholapaxy, 17 (45.94%) underwent percutaneous suprapubic cystolitholapaxy, and the remaining 15 (40.54%) underwent open cystolithotomy for bladder stones. The prostate (BPH) was managed by monopolar transurethral resection of prostate (TURP) in 14 (37.83%), bipolar TURP in 12 (32.43%), and laser prostatectomy (Holmium enucleation) in the remaining 11 (29.72%). At the time of discharge, all patients were free of bladder stones and voided well. At 3-month follow-up, the mean Q-max was 18.65 mL/s. CONCLUSIONS: Simultaneous management of BPH and bladder stones is safe and effective. The procedure chosen for managing bladder stones depends on the size, number, and experience of the surgeon. Smaller stones can be easily managed by minimally invasive procedures such as perurethral cystolitholapaxy and percutaneous cystolitholapaxy.

Keywords

• benign prostatic hyperplasia
• bladder stone
• cystolithotomy
• laser prostatectomy
• lithotripsy
• minimally invasive surgery
• transurethral resection of the prostate