Abstract
Introduction: The aim of this study was to compare the clinical outcomes of cystoscopy and laser resectoscope used during transurethral cystolithotripsy (TUC) and to evaluate the efficacy and reliability of these two endoscopic instruments. Methods: This study included patients who underwent transurethral bladder stone (BS) surgery between 2022 and 2025. Patients were categorized into cystoscope and laser resectoscope groups according to the endoscopic instrument used. Lithotripsy was performed using a holmium laser in all cases. Demographic characteristics, stone-related parameters, perioperative variables, and clinical outcomes were analyzed comparatively. Statistical analyses were performed using appropriate tests, and a p value <0.05 was considered statistically significant. Results: A total of 80 patients were included (Group 1: cystoscope, n = 40; Group 2: laser resectoscope, n = 40). No significant differences were found between groups regarding age, body mass index, number of stones, or stone size (p > 0.05). Operation and lithotripsy times were significantly shorter in the laser resectoscope group (29 vs. 45 min; 18 vs. 23 min, respectively; p < 0.001). Stone visualization quality was higher in this group, and mucosal bleeding was significantly less frequent (p = 0.014). No significant differences were observed regarding hospital stay, catheterization duration, or overall complication rates. Conclusion: Comparable stone-free and safety outcomes were achieved with TUC performed using either a cystoscope or a laser resectoscope. However, the laser resectoscope provided shorter operative times, improved visualization, and reduced mucosal injury, indicating that it is an effective and reliable alternative for TUC.
Plain Language Summary
Bladder stones are a common urological condition that can cause pain, difficulty urinating, and blood in the urine. They are most commonly treated by breaking them up through a small camera inserted into the bladder – a procedure known as transurethral cystolithotripsy using a holmium laser. During this procedure, surgeons can use two different types of instruments to guide the laser into the bladder: a standard rigid cystoscope or a laser resectoscope. While both instruments allow the surgeon to visualize and treat the stone, they differ in their design. The laser resectoscope features a continuous irrigation system that keeps the bladder filled with fluid throughout the procedure, whereas the standard cystoscope requires the bladder to be periodically emptied and refilled. In this study, we compared the surgical outcomes of 80 patients who underwent holmium laser bladder stone surgery using one of these two instruments. Our results showed that patients treated with the laser resectoscope had shorter operation times, better visualization of the stone during surgery, and less bleeding compared to those treated with the standard cystoscope. There were no significant differences between the two groups in terms of postoperative complications, length of hospital stay, or kidney function. These findings suggest that the laser resectoscope may offer practical advantages over the standard cystoscope for this type of surgery and may help surgeons make more informed decisions when selecting the appropriate instrument for their patients.
