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Management of bladder stones with pneumatic lithotripsy using a ureteroscope in children
Kenan Isen1, Suat Em, Vehbi Kilic
1Department of Urology, State Hospital of Diyarbakir, Diyarbakir, Turkey. kenanisen@hotmail.com
Insights
Pneumatic lithotripsy is a safe and effective treatment for pediatric bladder stones, offering minimally invasive benefits. While generally successful, careful patient selection is advised due to potential fragment passage issues.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Endourology
Background:
- Bladder stones in children can cause significant discomfort and health issues.
- Transurethral cystolithotripsy is a common treatment modality.
- Evaluating novel fragmentation techniques is crucial for improving outcomes.
Purpose of the Study:
- To assess the efficacy and safety of pneumatic lithotripsy for pediatric bladder stones.
- To determine the feasibility of using ureteroscopes for this procedure in children.
- To compare outcomes with existing treatment methods.
Main Methods:
- A cohort of 27 boys with bladder stones (
- A semi-rigid ureteroscope (Wolf or Storz) and pneumatic lithotripter were utilized for stone fragmentation.
- Data on operative time, hospitalization, follow-up, and complications were collected.
Main Results:
- All patients achieved stone-free status within 2 weeks post-procedure.
- The mean operative time was 22 minutes, with a mean hospitalization of 1.2 days.
- Mild hematuria was the only intraoperative complication; 7.4% experienced acute retention requiring a second procedure, and 7.4% had fever. No long-term issues or recurrences were noted.
Conclusions:
- Pneumatic lithotripsy with a ureteroscope is an effective and safe option for pediatric bladder stones.
- This minimally invasive approach reduces hospital stay and costs.
- Potential challenges with spontaneous fragment passage necessitate careful patient selection.
Purpose:
To evaluate the effectiveness and safety of pneumatic lithotripsy by using a ureteroscope to treat bladder stones in children.
Patients And Methods:
Twenty-seven boys presenting with bladder stones underwent transurethral cystolithotripsy. The indication for transurethral cystolithotripsy was stone size
Results:
All patients were stone-free at 2 weeks postoperatively. The mean age was 7.6 years (range 3-14 years), and the mean stone size was 14 mm (range 8-20 mm). The operating time was 22 minutes (range 10-46 minutes). The mean hospitalization time was 1.2 days (range 1-3 days), and the mean follow-up was 13 months (range 1-32 months). No complications due to pneumatic lithotripsy other than mild hematuria were observed intraoperatively. Stone forceps were used to retrieve large stone fragments (5-6 mm in size) in 10 (37%) of the patients. After the operation, acute retention was observed in 2 (7.4%) of the patients due to failure of fragments to pass through the urethra. A second procedure was performed on these patients. Fever was observed in 2 (7.4%) of patients. No long-term complications or stone recurrences were seen in any patient.
Conclusion:
Pneumatic lithotripsy using a ureteroscope appears to be an effective and safe treatment for bladder stones in children. It is minimally invasive and involves reduced hospital stay and overall cost. However, it can cause some problems in terms of spontaneous passage. Thus it may be used as an alternative treatment option in selected patients.
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