Simultaneous antegrade and retrograde endoscopic surgery for benign prostatic hyperplasia with vesical calculi – A single-centre experience

OBJECTIVE: To describe the effectiveness and safety of our novel technique of simultaneous percutaneous cystolithotripsy with transurethral resection of prostate (TURP) for patients with benign prostatic hyperplasia (BPH) complicated with large vesical calculi. PATIENTS AND METHODS: This was a retrospective analysis of 25 patients who underwent simultaneous percutaneous cystolithotripsy with TURP between January 2012 and January 2016. Technique: A 28-F Amplatz sheath was inserted percutaneously into the bladder after sequential dilatation under cystoscopic guidance. Percutaneous cystolithotripsy using a nephroscope and pneumatic lithoclast was then performed simultaneously along with monopolar TURP. Preoperative parameters reviewed included: patient’s symptoms, International Prostate Symptom Score, uroflowmetry pattern, prostate volume, and stone burden on ultrasonography of the abdomen and pelvis. Postoperative parameters analysed included: duration of irrigation, time until catheter removal, length of hospital stay, and complications. RESULTS: The mean age of the patients was 67.8 years. The mean prostate size was 62.28 mL and the mean stone burden was 3.18 cm. The mean operating time was 54.2 min. The mean time until catheter removal was 3.2 days. CONCLUSION: Simultaneous percutaneous cystolithotripsy with TURP in patients with BPH with large bladder calculi is safe and feasible.