Cystolithotomy Surgical Steps
Preoperative Patient Preparation
- Exclusion or treatment of a urinary tract infection
- Perioperative antibiotic prophylaxis
- Supine position with slight hyperextension of the lumbar spine
- Disinfection and draping
- Insert a transurethral catheter and fill the bladder with 200–300 ml
Surgical Technique
- Lower midline incision or Pfannenstiel incision
- Cut the linea alba
- After blunt dissection of the retropubic space (cavum retzii), insert a wound retractor
- Vertical cystostomy, which is secured with sutures to prevent further tearing
- Remove bladder stones, foreign bodies or bladder tamponade, controll bleeding.
- If necessary, perform simple prostatectomy
- If needed, insert a suprapubic catheter
- Close the bladder in two layers (mucosa – muscularis)
- Drainage of retropubic space
- Closure of the linea alba, skin closure
Open Suprapubic Cystolithotomy Surgery Video
References
