Stones in the urinary bladder and their endoscopic treatment. A contemporary approach

Introduction: the aim of our study was to obtain relevant characterization of patients with stones in the bladder and also to evaluate the results of endoscopic treatment in the conditions of a modern urological clinic. Materials and methods: the prospective study included data of 79 patients, who underwent endoscopic removal of stones from the bladder in urological departments of the university hospital of the Moscow State University of Medicine and Dentistry in 2016. Results: the mean age of the patients was 67± 11.87 years. The majority of them (n=67, 96.2%; CI: 89.4%-98.7%) were men. The most common complaint was frequent urination (51 patients, 64.6%; CI: 53.6%-74.2%) and hindered urination (49 patients, 62%; CI: 51%-71.9%). Hematuria was observed in 30 patients (38%, CI: 28.1%-49%). The majority of patients (n=64, 81%; CI: 71%-88.1%) had the disease for more than a year. 27 patients (34.2%, CI: 24.7%-45.2%) have previously undergone surgical treatment of upper urinary tract; 10 patients (12.7%, CI: 7%-21.8%) have hitherto got their stones removed from the bladder. Only 25 patients (35%, CI: 25.1%-46.8%) did not have any serious accompanying diseases. The most common etiological reason for the formation of stones in the bladder was benign prostatic hyperplasia (BPH) in 53 patients (67.1%, CI: 51.1%-76.4%). All patients underwent cystolithotripsy. Sufficient intraoperative and early postoperative complications were detected in 11 patients (13.9%). The most common complication was the necessity of performing conversion and cystolithotripsy, which was applied to 5 patients (6.3%, CI: 2.7%-14%). Discussion: the issues of etiopathogenesis of bladder stone formation were examined. We demonstrated the role of infravesicular obstruction, infection, the significance of surgical intervention in women and the possibility of cystolithotripsy. The study did not reveal any significant differences in sociodemographic and clinical characteristics of patients, in comparison with the data published in international scientific journals over the past 30 years. A nearly threefold increase in the percentage of patients with bladder stones, who had surgery due to BPH was reported, in comparison with the data from a multicenter European study. This fact indicates that outpatient monitoring of patients with infravesical obstruction is not effective enough. Conclusion: stones in the urinary bladder is still a relevant issue of modern urology. Transurethral cystolithotripsy is an effective and safe method of treating patients with bladder stones.