Anyone Have Experience With Bladder Stone Operation

[steveb]

Been diagnosed with large multiple bladder stones that need an operation to be removed. Anyone have experience with this and is laser an option.Also I am told I must wear a catheter for 2 weeks after the operation.

[FBN]

There is laser treatment for this condition; but what you may be referring to is ESWL (extra corporeal shockwave therapy). There are 2 different articles in Wikipedia; one describes Lithotripsy (ESWL) as a laser procedure, which is a different procedure. the conventional ESWL It is an acoustic wave (like ultrasound) that is applied, without any surgery, from outside the body to shatter the stone into smaller fragments that can be passed naturally. Can be used for kidney stones (90% of times), gall stones and some bladder stones but this depends on the size of the stone.

The laser method is more invasive.

If smaller than 5mm (usually kidney stones) this is not effective. It may be able to break up a larger bladder stones into smaller pieces that could be passed naturally but for a large stone, the surgical option is usually the only one.

Not major surgery but the bladder wall is cut to get access to the stone; hence the catheter for 2 weeks to allow the bladder to heal.

So it really depends on the size of the stone and then availability of these technologies.

ESWL is available in Bumrungrad and even smaller facilities but the laser option, best to check with the facility and treating physician.

This article is a good read: http://www.cornellurology.com/stones/treatments/surgical.shtml

[doggie888888]

I had my entire gall bladder removed many years ago, but I think you are seeking info on stone removal only. So am I right that you would not be interested in gall bladder removal?

[Sheryl]

I think he is referring to stones in the urinary bladder, not gall bladder.

Not an organ you'd want to have removed....

[steveb]

Thank you FBN for your information and yes Sheryl it is in the urinary bladder. I also have an enlarged prostrate. Since you say it is not major surgery do you think it would be too much to have a turp operation for the prostrate and remove the bladder stones at the same time.Not sure if this would be too much and better to have them done separately. If at all possible I would prefer laser if available and with laser would wearing a catheter for 2 weeks be the same as an operation? My doctor said if I have them both done at the same time I would have to wear 2 catheters. I'm confused about this. Thanks for all your help

[FBN]

The procedure again depends on the size of both the prostate and the stone/s. Open or radical prostatectomy is really mostly done for prostate cancer these days. If this is an option, it would be possible to do both at the same time. The 2 catheters are not clear. Definitely one in the bladder for both procedures. The doc may have meant that the second "catheter" would be placed at the operation site to drain any bleeding; not a catheter in the real sense but more a surgical drain; this is usually removed after 24 - 36h.

It would also be possible to remove stones, if they are small enough, when the TURP is done. Depending on the size and nature of the stone, it may be possible to use the laser or ESWL prior to the TURP but this is really for the specialist to advise.

[steveb]

Thanks again FBN for your reply.My doctor told me the bladder stones are larger than 2 centimeters and need surgery for removal. Also my prostrate is very large.I am using social security at a private hospital. I would prefer laser surgery for the bladder stones if the recovery time is less than open surgery. Could you recommend where I can get a second opinion. Not sure if my hospital does laser operations.

[FBN]

The following 2 urologists have been used by several TV members are come well recommended by them:

Dr Thanoo Choovichian at Samitivej

Dr. Viroj Chodchoy at Bumrungrad

The above is from the pinned topic on this forum "Urologist recommendations" by Sheryl. As far as I know, both physicians are still available at those hospitals but it would be best to check the hospital websites first.

Sheryl is the best resource for this but I assume that you are in BKK; if not, please indicate which location you would be able to get to..

[Sheryl]

Thanks again FBN for your reply.My doctor told me the bladder stones are larger than 2 centimeters and need surgery for removal. Also my prostrate is very large.I am using social security at a private hospital. I would prefer laser surgery for the bladder stones if the recovery time is less than open surgery. Could you recommend where I can get a second opinion. Not sure if my hospital does laser operations.

There isn't a laser surgery for bladder stones. The surgical options are only conventional open approach and endoscopic approach.

As FBN explained what you may be thinking of is lithotripsy (which may be done via sound waves, or laser, or other forces) which is an effort to break up the stones into smaller pieces so that they can pass. But at >2 cm this is not likely to work. It is generally recommended as first line treatment only for stones less than half that size and even then it doesn't always work.

No harm in getting other opinions on this tho. Much more importantly you really seem to need other opinions re your prostate. You say it is "enlarged", have you had a biopsy? If so, that is the first step. If you did and it is benign (BPH: beningn prostatic hyperplasia) the first line of treatment nowadays is medication, not surgery. Only if medication fails would other approaches be considered and even then there are less invasive and more effective options to a TURP, including microwave thermotherapy and needle ablation (both simple outpatient procedures, although in Thailand they might keep you in hospital a night). If a TURP really is needed then there are laser techniques for that.

Either of the urologists recommended above could advise you on all this.

[moobie]

A few years ago (in the UK) I had a 17mm diameter calcium oxalate stone removed. This was lodged in the lower, left ureter (the tube that runs from the kidney to the bladder). This was diagnosed with an endoscope camera and scan.

Because of the position wave treatment was not an option - from what I can gather this is used when stones are lodged in or near to the kidney. The treatment I did have involved an endoscope type device inserted through the urethra into the bladder and into the ureter where the stone was lodged. An attached percussive device was then used to shatter the stone into smaller pieces which were then caged and dragged out. Fortunately this was done under general anesthetic (the endoscope camera inspection wasn't).

The fact that the stone was lodged and removed from the ureter mean that I had to have a stent (a plastic tube)inserted between the Kidney and the bladder for a few weeks - more an uncomfortable feeling than a painful one. This was removed without anasthetic.

At no time did I have a catheter inserted.

The operation began around 5pm and I was actively awake and back in the ward around 7pm. I wanted to return home but was asked to stay overnight for general observation as I live alone.

Two points as a light warning - there may be more blood during the operation than expected (I expected none) and when you feel the need to urinate for the first time after the op accept painkillers if offered before hand. I didn't and endured a pain that I would keenly wish upon my worst enemies.

As for your prostate issue do research before hand as treatments are being brought forward all of the time and some of these do not have the effects oft associated with the traditional methods previously used.