Lithopaxy (removal of bladder stones)

What is this procedure?

This is a procedure in which bladder stones are fragmented or crushed through a telescope (cystoscope) that has been inserted into the bladder. The surgeon may use a lithotrite (crushing tool) or laser to disintegrate the stone(s).

Bladder stones do not always cause symptoms and may not need treatment, however whilst present they do pose a risk for developing a bladder infection.

What happens during the procedure?

You will usually have a “light” general anaesthetic (you will be asleep but breath for yourself), though occasionally a spinal anaesthetic is necessary. The anaesthetist will discuss this with you prior to the procedure. All methods minimise pain.

You will usually be given antibiotics during the procedure, after checking for any allergies – you will usually go home with a script for some more – a preventative measure against possible infection.

A telescope is inserted into the bladder up the urethra (water pipe) to see the stones. These are then broken up using a crushing instrument – the lithotrite, a mechanical disintegration probe or a laser. The stone fragments are removed from the bladder and, occasionally, a catheter is inserted.

What happens after the procedure?

Sometimes there is some bleeding from the bladder after the stones have been removed – they have rough surfaces and often rub against the surface of the bladder lining causing bleeding. Rarely, a catheter needs to be inserted - if so, you may remain in hospital overnight. Alternatively, you may prefer to go home with the catheter attached to a “leg bag”, and have it removed in the doctor’s rooms in a day or two, at your convenience.

Usually, you should be able go home the same day, and you should be able to resume normal activities relatively quickly.

Are there any side effects?

All procedures have the potential for side effects. Although these complications are well recognised, the majority of patients do not have problems after a procedure.

There are specific risks with this surgical procedure, and these will be discussed with you before your procedure.

Relatively Common

  • Mild burning or bleeding on passing urine for short period after operation.


  • Infection - requiring antibiotics.

  • Temporary insertion of a catheter.

  • Recurrence of stones or residual stone fragments.

  • Need for an additional procedure (e.g. resection of the prostate gland) if this is thought to be the cause of the stone formation.


  • Delayed bleeding requiring removal of clots or further surgery.

  • Injury to the urethra causing delayed scar formation.

  • Very rarely, perforation of the bladder requiring a temporary urinary catheter or return to theatre for open surgical repair.

What should I expect and do afterwards?

It is common to experience some burning when passing urine, as well as feeling the need to do so more often than normal. There may also be some light bloodstaining in the urine.

To help minimize any discomfort, you should:

  • Drink plenty of fluid – at least one glass an hour.

  • Take 2 Panadol tablets every 4 hours.

  • Take a sachet of Ural® or its equivalent every 4 hours. (HINT: take it with the Panadol).