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Holmium laser cystolithotripsy in children: initial experience
Prem A Ramakrishnan1, Mohammed Medhat, Younis H Al-Bulushi
1Department of Urology, Armed Forces Hospital, Muscat, Sultanate of Oman.
The Canadian Journal of Urology
|January 13, 2006
Summary
Transurethral Holmium: YAG (Ho: YAG) laser lithotripsy effectively treated pediatric bladder stones. This minimally invasive procedure proved safe and efficient, with no major complications or stone recurrence observed.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Laser Technology
Background:
- Pediatric bladder calculi management presents challenges.
- Current treatments include open surgery, cystolithotripsy, cystolithotomy, and shockwave lithotripsy.
- Holmium: YAG (Ho: YAG) laser lithotripsy offers a novel, minimally invasive approach.
Purpose of the Study:
- To evaluate the efficacy and safety of transurethral Ho: YAG laser lithotripsy for pediatric vesical calculi.
- To assess outcomes including stone-free rates, operative time, hospital stay, and long-term complications.
Main Methods:
- 23 children with vesical calculi (stone size ≤ 4 cm) underwent transurethral Ho: YAG laser lithotripsy.
- Calculi were fragmented using holmium laser energy via an 8F ureteroscope under video guidance.
- Post-operative evaluation included imaging and uroflowmetry at 3 and 18 months.
Main Results:
- The mean operative time was 38 minutes, with a mean hospital stay of 2.2 days.
- All children achieved stone-free status after a single session.
- No major laser-induced complications, stone recurrence, UTIs, or urethral strictures were noted at a mean follow-up of 42 months.
Conclusions:
- Transurethral Ho: YAG laser lithotripsy is an efficient and safe treatment for pediatric bladder stones.
- The procedure demonstrates excellent short-term and long-term outcomes.
- It represents a valuable minimally invasive option for managing vesical calculi in children.
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