Related Experiment Video
Updated: May 11, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Percutaneous suprapubic stone extraction for posterior urethral stones in children: efficacy and safety
Ahmed S Safwat1, Diaa A Hameed, Mohamed A Elgammal
1Department of Urology, Assiut University, Assiut, Egypt. assafwat@gmail.com
Insights
Percutaneous suprapubic stone extraction (PSPSE) effectively treats pediatric posterior urethral stones. This minimally invasive technique offers a safe alternative with high success rates and minimal complications for pediatric stone removal.
Area of Science:
- Urology
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Posterior urethral stones in children can cause acute urinary retention.
- Traditional stone extraction methods may involve significant morbidity.
Purpose of the Study:
- To assess the safety and efficacy of percutaneous suprapubic stone extraction (PSPSE) for pediatric posterior urethral stones.
- To evaluate PSPSE as a minimally invasive treatment option.
Main Methods:
- 54 boys with posterior urethral stones underwent PSPSE under general anesthesia.
- Stones were pushed into the bladder, grasped with a hemostat via a suprapubic puncture, and extracted or crushed.
- Procedure involved cystoscopic guidance and a 7F urethroscope.
Main Results:
- Successful stone retrieval (intact or fragmented) in all 54 patients.
- Mean operative time was 22 minutes.
- One patient experienced intraperitoneal extravasation requiring surgery; otherwise, minimal morbidity was observed.
Conclusions:
- PSPSE is a safe and effective minimally invasive treatment for pediatric urethral and bladder stones.
- Using a hemostat for extraction or crushing avoids the need for suprapubic tract dilation.
- This technique offers a low-morbidity alternative for pediatric stone management.
Objective:
To evaluate the safety and efficacy of percutaneous suprapubic stone extraction (PSPSE) for pediatric posterior urethral stones.
Methods:
Between July 2007 and June 2010, 54 boys presenting with acute urinary retention due to posterior urethral stones underwent PSPSE. Patients were a mean age of 66.4 months (range, 8-180 months). The stone size was 0.7-1.9 cm. Patients were placed under general anesthesia, and a 7F urethroscope was used to pushback the stone to the bladder. A 3-mm suprapubic puncture with a scalpel was performed, followed by insertion of a straight narrow hemostat through the puncture aided with cystoscopic guidance. The stone was grasped with the hemostat in its narrowest diameter and was extracted percutaneously or crushed if friable. The suprapubic puncture was closed with a single 4-0 Vicryl (Ethicon) suture.
Results:
Intact stone retrieval was achieved in 45 patients, and the stone was crushed into minute fragments in 9 patients. Intraperitoneal extravasation developed in 1 patient that required open surgical intervention. Mean operative time was 22 minutes. Patients were monitored for up to 17 months, with complete resolution of symptoms and stone clearance.
Conclusion:
PSPSE provides a minimally invasive approach for the extraction of urethral and bladder stones in the pediatric population. The use of a straight hemostat for suprapubic stone extraction or crushing is a good alternative to suprapubic tract dilation, with minimal morbidity.
Related Concept Videos
01:25Urinary Tract Calculi VI: Surgical Management
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
01:30Urinary Tract Calculi III: Medical Management
01:28Urinary Tract Calculi V: Nursing Management
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations