Novel technique for fragment removal after percutaneous management of large-volume neobladder calculi

Objective: To describe a novel method for fragment evacuation after percutaneous lithotripsy of neobladder calculi. Methods: The technique was developed using a Urovac bladder evacuator, which was attached to a standard 30F Amplatz working sheath. Results: The attachment of the Urovac evacuator to the Amplatz sheath rapidly evacuated large quantities of stone material. Careful attention should be paid to maintaining low-pressure irrigation by ensuring the bladder is not overly full and the Urovac device is not vigorously manipulated, to minimize the likelihood of bladder injury. Conclusion: Percutaneous ultrasonic/hydraulic lithotripsy for large-volume neobladder calculi often results in a substantial burden of stone fragments that can be difficult to clear using standard techniques. Attaching a Urovac bladder evacuator to the 30F Amplatz sheath can simplify the management of this task.