Mean Operative Time And Stay In Hospital Between Transurethral Removal Using Nephroscope And Percutaneous Cyst-lithotripsy In The Treatment Of Large Bladder Calculi

Original Article

Abstract

Background: urinary bladder stones comprise 5% of cases of urolithiasis1, with single calculi being identified in most instances but numerous calculi in 25% of cases2. With the development of endourological fiberoptic equipment and extracorporeal shockwave lithotripsy (swl), there have been notable modifications to managing and treating vescicolithiasis3. Thanks to this Study, we shall know the local amount of hospital stay and operating time between the two operations. We will suggest the method that results in a shorter surgical time and a shorter hospital stay since both have been successfully documented in the literature.

Objective: to compare the length of hospital stay and average operating time for transurethral removal of big bladder calculi using a nephroscope with percutaneous cystolithotripsy.

Study design : A randomized controlled trial

Duration and place of study: from January 1, 2020, to December 31, 2020, at the Department of Urology, Institute of Kidney Diseases and Transplant, Peshawar

Methodology: The Study used a randomized controlled trial (RCT) strategy, examining 60 individuals (30 in each group). The study covered all patients aged 20 to 65 years, female or male, presenting with bladder stones larger than 3 cm and with any number of rocks. All of the individuals who presented with renal insufficiency (defined as creatinine more than 3 mg/dl), active renal tract infection (defined as a fever greater than 38.5°c and positive urine culture), and obesity (defined as BMI greater than 30) were not included in the Study. The included patients were split into two groups using permitted blocks and blocked randomization. Patients in group b had percutaneous cystolithotripsy, whereas patients in group A underwent transurethral removal using a nephroscope. Following the operation, the length of hospital stay was calculated by tracking each patient until they decided to be discharged. After entering all of the data on the proforma into the statistical program SPSS version 23.0, a comparison analysis was carried out.

Results: according to our analysis, nine patients (30%) in group A were between the ages of 20 and 40, and 21 patients (70%) were between the ages of 41 and 65. In contrast, 15 (50%) patients in group b were between 20 and 40, and 15 (50%) were between 41 and 65. Seven patients (23%) and 23 patients (77%) in Group A were female, and in contrast, six patients (20%) and 24 patients (80%) in Group B were female. Group A had an average surgical duration of 35.06 minutes (sd ± 5) and an average hospital stay of 2.6 days (sd ± 0.9). In contrast, group b saw an average surgical duration of 44.06 minutes (sd ± 7) and an average hospital stay of 3.4 days (sd ± 1.02).

Conclusion: The Results Of Our Study Indicate That, When Treating Big Bladder Calculi, Transurethral Removal With A Nephroscope Had A Shorter Mean Operation Time And Hospital Stay Than Percutaneous Cystolithotripsy.

Keywords: Mean Operative Time, Hospital Stay, Nephroscope, Percutaneous Cystolithotripsy, Bladder