Objective: We reported two giant bladder stones cases, with significant comorbidities and mentally impaired patients, treated with PCCL. Case(s) Presentation: We report two cases of giant cystolithiasis (sized 8.8 cm x 7.2 cm and 7.0 cm x 5.8 cm) in male patients with impaired renal functions and mental illness. We performed PCCL on both patients with cystoscopy-guided bladder puncture and dilation, under spinal anesthesia. Stone fragmentation through transurethral (pneumatic) and percutaneous (suprapubic amplatz ultrasound) lithotriptors was performed simultaneously. Discussion: Stone fragments were evacuated through the nephroscope. These fluoroscopy-free procedures were performed under one hour. The patients were discharged on day three post-operatively without indwelling catheter. Conclusion: We performed PCCL with simultaneous transurethral fragmentation in giant bladder stone cases presenting with impaired renal functions and mental illness. We faced no significant post-operative issue. This technique, or its modified approach, is safe and applicable
Percutaneous cystolitholapaxy, bladder stones, urinary tract stone, comorbidity
Tahtali IN, Karatas T. Giant bladder stone: A case report and review of the literature. Turk. J. Urol. 2015; 40: 189–91.
Cicione A, De Nunizo C, Manno S, et al. Bladder stone management: an update. Minerva Urol. Nefrol. 2018; 70: 53–65.
Metwally AH, Sherief MH, Elkoushy MA. Safety and efficacy of cystoscopically guided percutaneous suprapubic cystolitholapaxy without fluoroscopic guidance. Arab J. Urol. 2016; 14: 211–5.
Kumar A, Dalela D, Dalela D, Goel A, Paul S, Sankhwar SN. The twin amplatz sheath method: A modified technique of percutaneous cystolithotripsy for large bladder stones in female patients. J. Surg. Tech. Case Rep. 2014; 5: 109–11.
Gamal W, Eldahshoury M, Hussein M, Hammady A. Cystoscopically guided percutaneous suprapubic cystolitholapaxy in children. Int. Urol. Nephrol. 2013; 45: 933–7.
Farshi A, Sari Motlagh R, Jafari Arismani R. Delivery of huge bladder stone in a thirty-five-year-old man. Nephrourol. Mon. 2015; 6: e20574.
Torricelli FC, Mazzucchi E, Danilovic A, Coelho RF, Srougi M. Surgical management of bladder stones: Literature review. Rev. Col. Bras. Cir. 2013; 40: 227–33.
Aron M, Goel R, Gautam G, Seth A, Gupta NP. Percutaneous versus transurethral cystolithotripsy and TURP for large prostates and large vesical calculi: Refinement of technique and updated data. Int. Urol. Nephrol. 2007; 39: 173–7.
Tugcu V, Polat H, Ozbay B, Gurbuz N, Eren GA, Tasci AI. Percutaneous versus transurethral cystolithotripsy. J. Endourol. 2009; 23: 237–41.
Demirel F, Cakan M, Yalcinkaya F, Demirel AC, Aygun A, Altug UU. Percutaneous suprapubic cystolithotripsy approach: For whom? Why? J. Endourol. 2006; 20: 429–31.