Laser Bladder Stone Removal | Bladder Stone Surgery

What is laser bladder stone removal?

Laser bladder stone removal is an endoscopic procedure to remove stones that have formed inside the bladder. A telescope (cystoscope) is introduced through the urethra — no skin incisions are made — and once the stone is visualised, laser energy is used to break it into small fragments. The fragments are then washed out through the cystoscope or collected using an irrigating syringe and basket device.

The laser can fragment stones of any composition efficiently and safely. Larger or harder stones may require more time to fully disintegrate.

Who needs laser bladder stone removal?

Bladder stones are detected on ultrasound or CT scan during investigation of urinary symptoms such as frequency, urgency, difficulty passing urine, pain at the end of urination, or blood in the urine. They most commonly develop in men with bladder outflow obstruction due to an enlarged prostate, which prevents complete bladder emptying and allows urine to stagnate. Other contributing factors include long-term urinary catheters, bladder diverticula, and neurological bladder conditions.

Laser bladder stone removal is the treatment of choice for most bladder stones. Small stones occasionally pass spontaneously, but those large enough to cause symptoms or that have persisted require endoscopic removal. Open surgery is rarely needed.

What to expect: before, during, and after

Before the procedure

Pre-operative assessment includes blood tests and urine tests. Imaging (ultrasound or CT) will already have confirmed the stone. If you take blood-thinning medication, you will be given guidance about pausing it. You will be asked to fast before the procedure.

During the procedure

The procedure is carried out under general or spinal anaesthesia. The cystoscope is introduced through the urethra and the stone is fragmented with laser energy. The fragments are thoroughly washed out. A urinary catheter is placed at the end of the procedure. If the procedure is combined with treatment of an enlarged prostate (such as HoLEP), the total operating time is longer.

After the procedure

Most patients go home the same day or the following day. The catheter is removed once the urine runs clear, typically within one to two days. Some blood in the urine for a few days after the procedure is normal. Drink plenty of fluids to help clear any remaining debris and reduce the risk of new stone formation.

Results and preventing recurrence

Laser bladder stone removal is highly effective at removing all visible stone material. A check cystoscopy at the end of the procedure confirms complete clearance. Postoperative imaging is not routinely needed unless there is doubt about completeness of removal.

Long-term prevention of bladder stone recurrence depends on addressing the underlying cause. In men with BPH, improving bladder emptying — through surgery such as HoLEP — substantially reduces the risk of further stone formation. Maintaining good hydration and regular follow-up with a urologist are also recommended.

Frequently Asked Questions

: Bladder stones most commonly form when the bladder does not empty completely, allowing minerals in concentrated urine to crystallise and accumulate over time. The most frequent underlying cause in men is bladder outflow obstruction due to an enlarged prostate (BPH). Other causes include a urinary catheter, neurological conditions affecting the bladder, or foreign bodies. Treating the underlying cause — for example by also performing HoLEP or TURP for BPH — is important to prevent stone recurrence.
: Yes. Cystolitholapaxy is performed under general or spinal anaesthesia. This ensures you are comfortable and that the surgeon can work safely and thoroughly inside the bladder.
: Most patients are treated as a day case or with one overnight stay. A urinary catheter is left in place for one to two days after the procedure to allow the bladder to settle and to ensure clear urine before discharge.
: Treating the underlying cause is important. If you have an enlarged prostate that contributed to stone formation, your urologist may recommend concurrent or subsequent surgery for BPH — such as HoLEP or TURP — to reduce the risk of stone recurrence. Drinking adequate fluid daily helps prevent stone formation in general.

Book a consultation

To find out whether this procedure is appropriate for you, please contact the secretary.