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Learn About Conditions and Procedures

What is Trauma?

Trauma is a serious injury or shock to the body. It is caused by a physical force such as violence or an accident. The injury may be complicated by psychiatric, behavioral, and social factors.

It is critical to have an entire team immediately available to provide care to an injured patient 24-hours a day. This teamwork starts at the scene of the injury where a coordinated, statewide pre-hospital medical system rapidly transports the injured patient from the scene to the hospital providing the appropriate level of care according to criteria established in the statewide trauma regulations. Once at the hospital, a complete team of surgeons, emergency physicians and nurses continue the life-saving treatment.

This team approach to care of the injured patient has had a dramatic impact on saving lives.

Minimally Invasive Procedures for Massive Bleeding

Injuries take many forms. The most advanced hospitals can treat injuries with a variety of approaches that involve well-known ones, like surgery, and newer ones where minimally invasive procedures can replace some surgeries.

As a Level 1 Trauma Center, Hartford Hospital has Interventional Radiologists as part of the Trauma Team. They perform procedures such as "embolization" which is a recognized interventional radiology technique that is used to treat trauma patients with massive bleeding.

Click here to see some of the advanced interventional techniques available at Hartford Hospital.

Learn more about trauma, or search below to learn about other health conditions.

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Cystolitholapaxy

Pronounced: sis-TOE-litho-lay-pak-see

by Deanna M. Neff, MPH

En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

Cystolitholapaxy is a procedure to break up bladder stones into smaller pieces and remove them. Bladder stones are minerals that have built up in the bladder. Ultrasonic waves or lasers may be delivered through a tool called a cystoscope to break up the stones.

Bladder Stone

Reasons for Procedure

This procedure is done to treat bladder stones.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like

Urinary tract infection
Bladder tear or damage
Bleeding
Reaction to the anesthesia
Infection
Damage to internal tissue or structures

What to Expect

Your doctor may do the following:

Physical exam and medical history
Blood and urine tests
Imaging tests

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, including:

Aspirin or other non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen
Blood thinners, such as warfarin
Anti-platelets, such as clopidogrel

Other things to remember before the procedure:

Arrange for a ride home from the care center.
If instructed by your doctor, do not eat or drink for eight hours before the procedure.

This procedure can be done under local, spinal, or general anesthesia. It will block any pain. Sedation may also be used to ease anxiety.

With local anesthesia, a special jelly or fluid will be inserted into your urethra. This will numb the area. If you are having spinal anesthesia, it will be injected into your spine. General anesthesia will make you stay asleep during the procedure.

The doctor will place a tiny flexible probe, called a cystoscope, through your urethra toward the bladder. The probe has a camera for viewing. Imaging guidance, like ultrasound, will help the doctor locate the bladder stones. A saline solution may be flushed through the urinary tract. After a stone is located, the doctor will grab the stone and turn on the device to break it. A special basket or forceps will be used to grab the stone fragments and remove them.

The bladder and surrounding structures will be examined. The doctor may place a stent in your urethra to help protect the lining while the fragments pass or to repair damage.

Depending on the type of anesthesia used, you may be able to move around after the procedure. You may still have a catheter inside your urethra.

This is usually done in an outpatient setting. You will not need to stay overnight. The procedure takes 30-60 minutes depending on the size of the stones.

Anesthesia prevents pain during the procedure. Ask your doctor about medication to help with pain after the procedure.

After the procedure, the care center staff may provide the following care:

Monitor you while you recover from the anesthesia and/or sedation
Remove any IV needles and the catheter
Help you to eat and move around again
Give you pain medication

When you return home, do the following to help ensure a smooth recovery:

Take medication as directed to reduce pain and the chance of infection
Avoid difficult activity and heavy lifting
Drink plenty of fluids
Do not drive or have sex until your doctor says it is safe to do so
Be sure to follow your doctor’s instructions

Call Your Doctor

Call your doctor if any of the following occurs:

Increasing pressure or pain while passing urine
Pain in the back or abdomen
Not able to urinate
Changes in frequency, odor, appearance, or volume of urine
Signs of infection, including fever or chills
Blood or blood clots in urine after the first few days
Painful urination or a burning sensation after the first few days
Leaking urine

If you think you have an emergency, call for medical help right away.

American Urological Association Foundation

http://www.urologyhealth.org

National Institute of Diabetes and Digestive and Kidney Diseases

http://www.niddk.nih.gov

Canadian Urological Association

http://www.cua.org

Kidney Foundation of Canada

http://www.kidney.ca

Cystoscopy and ureteroscopy. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/cystoscopy/. Updated March 28, 2012. Accessed May 22, 2013.

Cystoscopy for women. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/gynecology/cystoscopy_for_women_92,P07723/. Accessed May 22, 2013.

Marickar YM, Nair N, Varma G, et al. Retrieval methods for urinary stones. Urol Res. 2009;37(6):369-376.

Stoller ML. Chapter 16. Urinary Stone Disease. In: Tanagho EA, McAninch JW, eds. Smith's General Urology. 17th ed. New York: McGraw-Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=3127288. Accessed May 22, 2013.

Urinary calculi. Merck Manual for Healthcare Professionals. Available at: http://www.merckmanuals.com/professional/genitourinary_disorders/urinary_calculi/urinary_calculi.html. Updated November 2012. Accessed May 22, 2013.

Last reviewed May 2013 by Adrienne Carmack, MD; Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.