Related Experiment Videos
Catheter-less suprapubic cystolithotomy in children
R B Sabnis1, R M Desai, D P Patil
1Department of Urology, Lokmanya Tilak Municipal General Hospital and Medical College, Bombay, India.
Insights
Meticulous two-layer bladder closure after suprapubic cystolithotomy for pediatric bladder stones can eliminate the need for post-operative catheter drainage, simplifying recovery.
Area of Science:
- Pediatric Urology
- Surgical Procedures
- Stone Disease Management
Background:
- Bladder stones in children are prevalent in developing nations.
- Suprapubic cystolithotomy is the standard surgical approach for pediatric bladder stones.
- Post-operative bladder drainage via catheter is conventional to prevent urinary leakage.
Purpose of the Study:
- To evaluate the efficacy of omitting post-operative bladder catheterization in children undergoing suprapubic cystolithotomy.
- To determine if meticulous two-layer bladder closure negates the need for urinary drainage.
Main Methods:
- Analysis of 86 pediatric patients treated with suprapubic cystolithotomy without post-operative catheterization.
- Detailed recording of stone size and intra-operative findings.
- Assessment of patient outcomes based on the surgical technique.
Main Results:
- Excellent outcomes were achieved in 85% of patients.
- Satisfactory results were reported in 10% of cases.
- Unsatisfactory results were observed in 4.7% of patients.
Conclusions:
- Meticulous two-layer closure of the bladder during suprapubic cystolithotomy allows for the safe omission of post-operative catheter drainage in pediatric patients.
- This approach simplifies post-operative care and potentially reduces complications associated with catheter use.
- The study highlights the importance of surgical technique in optimizing outcomes for pediatric bladder stone removal.
Abstract:
Bladder stones in children are common in developing countries and the procedure of choice for their removal is suprapubic cystolithotomy. It is standard practice to drain the bladder for a few days post-operatively to prevent urinary leakage. We have observed that, if the bladder is closed meticulously in 2 layers, bladder drainage by means of a catheter is not required. We have analysed 86 children treated by suprapubic cystolithotomy without a catheter. Size of the stones and intra-operative findings were noted and it was found that 85% of the patients had an excellent result; 10% had a satisfactory result and 4.7% were unsatisfactory. The advantages of the procedure and selection of the patients are discussed.