Introduction: Radical cystectomy with the removal of bladder and adipose tissue attached to it adjacent to nearby organs such as the prostate and seminal vesicles in the man and the uterus, and the anterior part of the vagina in the woman represent the "gold standard" in the ca. Bladder with a mortality that has progressively decreased to reach levels ranging between 1.2% and 3.7% in Europe, the formation of new vascular calculus usually occurs on the points used in the creation of a new vascular system or as a result of stagnation Postnatal urine in the new vascular system, which predisposes to the onset of infections; Calculations can usually be treated endoscopically, and rarely require an open-air surgery; The purpose of the present study and that through the exposure of clinical observation data to study and evaluate the various solutions of this complication Materials end Methods: January 2015 to December 2016 at the II Clinical Surgery and Digestive Surgery Department of General Ophthalmology and Specialized Polyclinic II University of Catania No 2 patients aged 55-79 years average age 67. Male sex Hospitalization patients had a clinical symptom characterized by; Hematuria fever uro septica piuria The ultrasound diagnostic of renal calculus based on the direct calculation of the calculus; The radiographic examination without direct contraction of the abdomen (Rx) practiced as the first CT examination is an accurate imaging technique, presenting the advantage of a high speed and a more favorable cost-effectiveness index confirmed the presence of bulky calculations that occupied 2/3 of the bladder and new vescicaal surgical treatment with an epicystolitotomy with removal of calculations of the weight of 200g and 500g. It was 5gg in the absence of complications Results: The pathogenesis of bladder calculus is often due to a cervicouretral obstruction, and the subsequent bladder stagnation its treatment should also result in the resolution of the latter disease. Discussion: Therapeutic interventions Open air surgery is 2-5.4%. The most common indications are complex calculus or calculation size, renal function exclusion, failure of other less invasive methods (SWL, PCNL), The coexistence of anatomical malformations (infundibular stenosis, particularly in the frontal calciferous calcification, concurrent urethral joint stenosis, urteteral stenosis), obesity or other co-morbidity, the need for concomitant surgery, the patient's choice. [27 The intraoperative use of ballistic lithotripsy during open-air kidney surgery can increase the effectiveness of stone free (88%), morbidity, surgical times, blood loss, hospitalization time and post-surgical renal damage. Conclusions: Open surgery should be reserved for the treatment of cases of very large (giant) or complicated forms of kidney stones, of other methods of failure, of coexistence of anatomy-endoscopic malformations, of severe obesity or other comorbidities, of need Concomitant open surgery or explicit patient choice
