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Safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in children
Ali Sher Khosa1, Muhammad Hussain, Manzoor Hussain
1Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi. info@siut.org
Insights
Transurethral pneumatic lithotripsy is a safe and effective treatment for pediatric bladder stones up to 3cm. This minimally invasive procedure offers high stone-free rates with minimal complications in children.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Endourology
Background:
- Bladder stones (calculi) in children can cause significant discomfort and complications.
- Traditional stone removal methods may be invasive and carry risks.
- Evaluating minimally invasive options is crucial for pediatric stone management.
Purpose of the Study:
- To assess the safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in pediatric patients.
- To determine the success rate and complication profile of this procedure in children.
Main Methods:
- A descriptive study involving 100 children (up to 15 years) with bladder stones (up to 3cm).
- Procedure performed using a mini-scope or semi-rigid ureteroscope with a pneumatic lithoclast under general anesthesia.
- Data collected on procedure duration, complications, and hospital stay; stone clearance assessed by ultrasound post-procedure.
Main Results:
- The mean age of patients was 4.95 years; male-to-female ratio was 11.5:1.
- Mean hospital stay was 9.2 hours, with a mean operating time of 25 minutes.
- Minor complications occurred in 10% (hematuria 5%, dysuria 4%), with 1% experiencing post-operative urinary retention. All patients achieved stone clearance.
Conclusions:
- Transurethral pneumatic lithotripsy is a highly effective and safe treatment for pediatric bladder stones up to 3cm.
- The procedure demonstrates a favorable safety profile and excellent stone clearance rates in children.
- This technique offers a valuable minimally invasive option for pediatric urolithiasis.
Objective:
To determine the safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in children.
Method:
The study included 100 children up to 15 years of age undergoing pneumatic cystolithoclast for bladder stones. The descriptive study was conducted from September 2006 to February 2007 at the Sindh Institute of Urology and Transplantation, Karachi. The inclusion criteria was children up to 15 years of age with a bladder stone of up to 3cm, pre-operative negative urine culture, no coagulopathy and fit for general anaesthesia. An X-ray and ultrasound of Kidney and Urinary Bladder (KUB) was mandatory. The procedure was done under general anaesthesia with a single dose of pre-operative antibiotic. A mini-scope of 4FR or a semi-rigid ureteroscope of 7/8.5 FR with pneumatic wolf lithoclast was used for the fragmentation of stones. Duration of procedure, any per-operative and post-operative complications and the duration of hospital stay were recorded. Post-operatively, the patient underwent ultrasound Kidney and Urinary Bladder at the first follow-up to assess stone clearance after one week.
Result:
Mean patients age was 4.95 +/- 3.3 years. The male-to-female ratio was 11.5: 1 The mean hospital stay was 9.2 +/- 2.5 hours. The mean operating time was 25 (10 -65) minutes. Ten (10%) patients developed minor complications out of which 5 (5%) developed haematuria and 4 (4%) developed difficulty in passing urine. One (1%) of the patients developed post-operative retention of urine. All the patients were stone-free after the procedure.
Conclusion:
The transurethral pneumatic lithoclast is very effective and safe in children with bladder stones up to 3cm.
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