Comparison of Transurethral use of Nephroscope with Cystoscope in Transurethral Cystolithotripsy

Aim: Our aim was to compare the efficacy and safety of transurethral use of a nephroscope via Amplatz sheet with the transurethral use of cystoscope for the treatment of large bladder stones. Material and Method: A total of 46 male patients with a bladder stone ≥3 cm were included. Patients were randomized into two groups. Group 1  consisted of 24 patients whom bladder stone was fragmented by the transurethral use of a nephroscope via 26F Amplatz sheath and Group 2  consisted of 22 patients who were treated by the transurethral use of a cystoscope. Stone clearance was assessed by the KUB film at the second postoperative day. At the postoperative third month, retrograde urethrogram and uroflowmetry was done on all patients to evaluate the possible postoperative urethral stricture. Thereafter, all patients were followed up by the KUB film and ultrasonography for every 6 months.Results: All stone fragments were removed completely in every patient. Access number within the Amplatz sheath  in group 1 was significantly lower than the transurethral access number in group 2. The mean operative time for stone removal in group 1 and 2 was         42.00 ± 7.30 min and 59.14 ± 10.62 min, respectively (P ≤0.0001). The mean operative time for stone removal was significantly shorter in group 1. During the follow-up period, none of the patients developed urethral stricture nor recurred. Discussion: Treatment of large bladder stones by a nephroscope via transurethrally placed Amplatz sheath is a fast and effective treatment modality compared to endoscopic treatment via cystoscope