Abstract
Objective: To evaluate the safety and efficacy of cystolitholapaxy performed under local anesthesia at a tertiary care hospital.
Methodology: This prospective study was conducted over six months at the Department of Urology, Asian Institute of Medical Sciences, Hyderabad. Fifty patients with single bladder stones <2 cm underwent cystolitholapaxy under local anesthesia. Standard endoscopic techniques were used. Pain was assessed via VAS. Data on demographics, stone characteristics, and complications were analyzed using SPSS v26. Logistic regression identified predictors of complications, with model fit confirmed by the Hosmer-Lemeshow test.
Results: Fifty patients (mean age 36.54±9.03 years) had stones averaging 1.38±0.32 cm. Mean procedure duration was 5.46±1.03 minutes. Postoperatively, 24 (48%) experienced mild pain, 23 (46%) had moderate pain, and 3 (6%) developed urinary retention requiring catheterization. Logistic regression showed that age, stone size, and procedure duration did not significantly predict postoperative complications (p>0.05 in all). Odds ratios indicated no strong association between these variables and adverse outcomes, either individually or in combination, suggesting the procedure is generally safe and well-tolerated across varied patient profiles.
Conclusion: Transurethral cystolitholapaxy under local anesthesia appears safe and well-tolerated for selected patients in a tertiary care setting. Though promising, these findings warrant validation through larger studies with long-term follow-up. Future research should also compare techniques and anesthesia types to optimize bladder stone management and improve patient outcomes.

Key words: Cystolitholapaxy, local anesthesia, bladder stones, urolithiasis.