Comparison of three different endoscopic approaches in the treatment of bladder calculi

Background: This study compared the following three endoscopic techniques used to treat bladder stones: transurethral cystoscope used with a pneumatic lithoclast or nephroscope used with a pneumatic lithoclast and nephroscope used with an ultrasonic lithoclast. Methods: Between January 2013 and May 2016, 107 patients with bladder stones underwent endoscopic treatment. Patients were classified into three groups based on the endoscopic techniques and energy modalities used in each group as: group 1 (transurethral stone removal using a cystoscope with pneumatic lithoclast), group 2 (transurethral stone removal using a nephroscope with pneumatic lithoclast), and group 3 (transurethral stone removal using a nephroscope with ultrasonic lithoclast). Baseline and perioperative data were retrospectively compared between three groups. Results: No statistically significant intergroup differences were observed in age, sex ratio, and stone size. A statistically significant intergroup difference was observed in the operation time-group 1, $71.3{\pm}46.6min$; group 2, $33.0{\pm}13.7min$; and group 3, $24.6{\pm}8.0min$. All patients showed complete stone clearance. The number of urethral entries was higher in group 1 than in the other groups. Significant complications did not occur in any patient. Conclusion: Nephroscopy scores over cystoscopy for the removal of bladder stones with respect to operation time. Ultrasonic lithoclast is a safe and efficacious modality that scores over a pneumatic lithoclast with respect to the operation time.