Percutaneous Cystolithotomy in Augmented Bladders.

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery

Background:

• Augmented bladders, often resulting from bladder exstrophy repair, have a high incidence and recurrence rate of bladder stones.
• Recurrent open cystolithotomy is challenging and less preferred due to scarred tissues from previous surgeries.

Purpose of the Study:

• To evaluate the efficacy and safety of percutaneous cystolithotomy (PCCL) for bladder stone removal in children with augmented bladders.
• To adapt an established adult procedure for a pediatric population with complex bladder reconstructions.

Main Methods:

• PCCL was performed in three pediatric patients with augmented bladders.
• A suprapubic needle track was created under cystoscopic guidance.
• Bladder stones were removed using graspers through a dilated track and laparoscopic cannula.

Main Results:

• PCCL demonstrated a good outcome in the augmented bladders.
• No adverse effects on continence or bladder capacity were observed post-procedure.
• Skin tissue patches were noted in native bladders during cystoscopy.

Conclusions:

• PCCL is a viable and effective minimally invasive option for bladder stones in augmented bladders in children.
• High stone recurrence may be linked to keratin from dermal tissue within the augmented bladder.
• Further investigation into techniques like shaving or fulguration during reconstruction may reduce stone formation incidence.