Paediatric cystolitholapaxy using mini PCNL-kit through the Mitrofanoff stoma

Area of Science:

• Urology
• Pediatric Surgery

Background:

• Bladder stones (cystolithiasis) frequently complicate augmentation cystoplasty and urinary diversion in children with neuropathic bladders.
• Treating recurrent stones in these patients is challenging, with open procedures carrying significant morbidity.

Observation:

• A case report details the management of a 14-year-old patient with neurogenic bladder (myelomeningocele) and recurrent bladder stones post-bladder augmentation.
• The patient underwent Mitrofanoff cystolitholapaxy utilizing a mini PCNL kit.

Findings:

• A novel modification involved using a Nelaton catheter for gentle dilation of the Mitrofanoff stoma prior to Amplatz sheath insertion.
• High-energy Holmium laser lithotripsy facilitated complete stone clearance in a single procedure, even with a large stone burden.

Implications:

• This modified mini-PCNL approach through the Mitrofanoff channel presents a safe, effective, and minimally invasive option for managing complex bladder stones in pediatric patients.
• The technique offers a potentially lower-morbidity alternative to open surgery, improving stone-free rates and patient outcomes.