Clinical effect of transurethral lithotomy of bladder calculus in high-risk anesthesia patients under local anesthesia

doi:10.3877/cma.j.issn.1674-3253.2026.01.007

Abstract

Abstract:

Objective

To explore the effectiveness of transurethral lithotomy of bladder calculus in high-risk anesthesia patients under local anesthesia (LA).

Methods

The clinical data of 30 bladder calculus patients underwent transurethral lithotomy using ureteroscope under LA in the Department of Urology, Nanjing Drum Tower Hospital from September 2021 to May 2024 were collected. The general clinical data (age, gender, ASA grade, stone number, stone size, comorbidity) and postoperative clinical data (surgical time, blood loss, postoperative hospital stay, postoperative complications) were analyzed. The surgical effects were evaluated by analysing the Visual Analogue Scale (VAS) scores at various stages of the procedure during local anesthesia, as well as the stone-free rate (SFR).

Results

30 cases of primary transurethral lithotomy of bladder calculus under LA were completed, including 29 males and 1 female. The operation time was (69.00±24.73) minutes, the blood loss was (4.00±3.21) ml, and the postoperative hospital stay was (2.41±1.40) days. At each stage of procedure, the VAS was (1.73±0.64) for ureteroscopy, (3.43±0.77) for holmium laser/pneumatic ballistics lithotripsy, (2.33±0.84) for placement of sheath, (1.80±0.76) at 1 h after operation and (1.33±0.71) at 8 h after operation. The lithotripsy had the highest score of pain, and the placement of sheath followed. Postoperative complications included 5 cases of gross hematuria, 3 cases of nausea and vomiting, and 2 cases of fever. None serious complications like septic shock were observed. The SFR of patients was 93.33%(28/30).

Conclusion

After strict preoperative assessment and adequate preparation, transurethral lithotomy of bladder calculus can be attempted for patients with high-risk anesthesia.

Key words: Bladder calculus, Transurethral lithotomy, Local anesthesia, High-risk anesthesia

Xiang Du, Limei Liu, Hongqian Guo, Rong Yang. Clinical effect of transurethral lithotomy of bladder calculus in high-risk anesthesia patients under local anesthesia[J]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(01): 51-55.

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