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Minimally invasive percutaneous cystolithotomy: an effective treatment for bladder stones in infants aged <1 year
Weidong Gan1, Hongqian Guo, Rong Yang
1The Affiliated Drum Tower Hospital of Nanjing University, Department of Urology, Nanjing, Jiangsu, China.
Insights
Minimally invasive percutaneous cystolithotomy (MPCCL) effectively treats bladder stones in infants under one year old. This procedure offers a safe option with reduced complications and shorter hospital stays for pediatric patients.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Pediatric Endourology
Background:
- Bladder stones in infants are rare but require effective treatment.
- Traditional methods may involve higher morbidity in this age group.
Purpose of the Study:
- To evaluate the safety and efficacy of minimally invasive percutaneous cystolithotomy (MPCCL) for treating bladder stones in infants younger than one year.
- To assess outcomes including stone-free status, procedure time, blood loss, complications, and hospital stay.
Main Methods:
- A retrospective review of 15 male infants (<1 year) who underwent MPCCL for bladder stones between 2003 and 2008.
- MPCCL involved creating a percutaneous tract, inserting a ureteroscope, and fragmenting stones with a shock wave lithotriptor.
- Postoperative management included suprapubic and urethral catheters, with stone-free status confirmed by imaging.
Main Results:
- All 15 infants achieved a stone-free status after a single MPCCL procedure.
- The mean procedure time was 25 minutes with minimal blood loss.
- Few perioperative complications were observed, and the mean hospital stay was 2.8 days.
Conclusions:
- Minimally invasive percutaneous cystolithotomy (MPCCL) is a safe and effective treatment for bladder stones in infants.
- MPCCL leads to reduced postoperative complications and shorter hospital stays compared to other potential treatments.
Objective:
To present our experience with minimally invasive percutaneous cystolithotomy (MPCCL) for the treatment of bladder stones in infants aged <1 year.
Patients And Methods:
From 1 January 2003 to 31 October 2008, 15 boys with a mean (range) age of 8.2 (3.0-11.5) months underwent MPCCL. The mean (range) stone diameter was 1.4 (0.9-2.2) cm. Ten infants had a solitary stone while five had more than one stone. MPCCLs were performed under general anaesthesia. A 16 F peel-away sheath was introduced as a working tract after dilatation with percutaneous nephrolithotomy dilators (8-16 F) under fluoroscopic control. After dilatation, an 8-9.8 F ureteroscope was introduced into the bladder, and the stones were fragmented with a shock wave lithotriptor. After the MPCCL, a 14 F suprapubic catheter was left in situ and fixed to the skin, and removed 1 or 2 days after MPCCL. The urethral catheter was removed 2 or 3 days after MPCCL. The absence of stone fragments on plain X-ray/ultrasonography was considered as a 'stone-free' status.
Results:
All infants were stone-free after one MPCCL; no recurrent stones developed. The mean MPCCL procedure time was 25 min and intraoperative blood loss was scant. Perioperative complications were few. The mean hospital stay was 2.8 days.
Conclusion:
MPCCL is a safe and effective treatment option for bladder stones in infants, reducing postoperative complications and shortening hospital stay.
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