The management of vesical calculi with combined optical mechanical cystolithotripsy and transurethral prostatectomy: is it safe and effective?

Objectives. To investigate the effectiveness and reliability of the combina tion of optical mechanical cystolithotripsy (OMC) and transurethral prostat ectomy (TURP) for the treatment of bladder calculi and obstructive benign p rostatic enlargement (BPE). Patients and methods. From December 1990 to December 1996, 61 patients who had bladder stones and BPE or bladder neck contracture were treated with co mbined OMC and TURF: 32 patients who had bladder stones with no infravesica l obstruction were treated with OMC alone. The records of a random selectio n of 97 patients with obstructive BPE who were treated with TURF only in th e same period were used as the control. The operative duration lime, the le ngth of hospital stay. the duration of urethral catheterization, outcome an d complications of the procedures for each patients were reviewed. The Mann -Whitney U-test and chi-square tests were used for statistical analysis. Results. The mean duration of surgery, hospital stay and urethral catheteri zation were significantly longer with combined OMC and TURF than with OMC a lone (P < 0.05). Stone-free rates were 94% after OMC alone and 93% after co mbined OMC and TURP. The postoperative mean peak flow rates were 14.3 mL/s after the combined procedure and 15.2 mL/s after TURF alone. The complicati on rates were 21% for the combined procedure and 13% for OMC alone. The com plication rate of TURP was 5%, significantly lower than that for the combin ed procedure (P < 0.05). Conclusion. Bladder stones were associated with infravesical obstruction in two-thirds of patients. Simultaneous treatment with OMC and TURF did not c hange the effectiveness of these procedures, but caused additional morbidit y.