Closed system pneumatic impact lithotripsy

A method for removing uroliths from the urinary bladder of a non-human, non-laboratory animal, comprising:

• (a) performing a urethrostomy by making a urethrostomy incision and then inserting a collapsed flexible pouch assembly through the urethra and into the bladder, the flexible pouch assembly comprising an elongated handle having an actuator at a first end and a collapsible support rim at a second end and a flexible pouch having a mouth around the collapsible support rim;
• (b) opening the flexible pouch in the bladder by actuation of the actuator outside of the animal;
• (c) identifying a urolith transrectally without any visual observation, and placing the urolith into the open mouth of the flexible pouch by transrectal manipulation without any visual observation and by feeling the support rim at the open mouth of the flexible pouch;
• (d) exteriorizing an opening of the flexible pouch through the urethrostomy incision;
• (e) removing the elongated handle and collapsible support rim from the flexible pouch assembly such that the open mouth of the flexible pouch is outside of the animal;
• (f) inserting a pneumatic device into the open mouth of the flexible pouch;
• (g) fragmenting the urolith while the urolith is in the opened flexible pouch while manually stabilizing the urolith transrectally;
• (h) removing the fragments using sponge forceps and/or flushing the fragments of the urolith out of the flexible pouch;
• and then
• (i) removing the flexible pouch from the bladder,
• wherein the urolith is inserted into the open mouth of the flexible pouch inside the bladder manually without any visual observation and,
• wherein the pneumatic device is inserted into the open mouth of the flexible pouch outside of the animal.