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Percutaneous treatment of bladder calculi in children: 5 years experience
Hassan Ahmadnia1, Mehdi Younesi Rostami, Ali Asghar Yarmohammadi
1Department of Urology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. ahmadnia2001@yahoo.com
Insights
Percutaneous suprapubic cystolithotripsy safely and effectively removes bladder stones in children. This minimally invasive procedure is recommended for large calculi, offering a high success rate with minimal complications.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Pediatric Endourology
Background:
- Bladder calculi (stones) pose a significant health concern in pediatric populations.
- Evaluating minimally invasive treatment options for pediatric bladder stones is crucial.
Purpose of the Study:
- To assess the safety and efficacy of percutaneous suprapubic cystolithotripsy for treating bladder calculi in children.
- To determine the feasibility of this technique for pediatric patients with large bladder stones.
Main Methods:
- A cohort of 30 children with bladder calculi underwent percutaneous stone removal.
- The procedure involved a suprapubic incision, tract dilation, and stone fragmentation/removal using a nephroscope.
- The technique was performed without fluoroscopic guidance, with a urethral catheter placed postoperatively.
Main Results:
- All 30 patients achieved stone-free status following the procedure.
- The mean operative time was 23.13 minutes, with no significant intraoperative or postoperative complications reported.
- Most patients were discharged within 24 hours, indicating a rapid recovery.
Conclusions:
- Percutaneous suprapubic cystolithotripsy is a safe and efficient treatment for pediatric bladder calculi.
- This technique is particularly effective for large bladder stones (greater than 1 cm) in children.
- The study supports the recommendation of this minimally invasive approach for pediatric stone management.
Introduction:
We sought to evaluate the safety and efficacy of percutaneous cystolithotripsy in children.
Materials And Methods:
Thirty children (27 boys and 3 girls; mean age, 6.06 +/- 2.64 years; range, 1.5 to 12 years) with bladder calculi underwent percutaneous stone removal. The mean size of the largest diameters of the calculi was 24.8 +/- 8.47 mm (range, 13 mm to 50 mm). Under general anesthesia, a 1-cm incision was made 1 to 2 cm above the pubic symphysis. A 26-F nephroscope was introduced into the bladder following tract dilation, and the calculi were removed. If the calculi were larger than 1 cm, fragmentation was performed. The procedure was done without fluoroscopy. Finally, a urethral catheter was placed for 48 hours.
Results:
All patients became stone free. The mean operative time was 23.13 +/- 8.38 minutes (range, 12 to 40 minutes). All patients were discharged 24 hours after operation, except 1, who was hospitalized 2 more days for suprapubic pain and severe irritating symptoms. No significant intraoperative or postoperative complications were seen.
Conclusion:
Percutaneous suprapubic cystolithotripsy is an efficient and safe technique for treating bladder calculi in children. We recommend this technique for treating large bladder calculi (larger than 1 cm) in children.
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