Abstract
Purpose
To evaluate the safety and efficacy of endoscopically guided percutaneous suprapubic artery forceps litholapaxy for pediatric vesical and posterior urethral stone <1 cm in diameter.
Materials and methods
A retrospective series study of 73 children (68 boys and 5 girls) with vesical and urethral stones less than 1 cm in diameter with an average age of 3.5 years (range 1–9 years) were included in this study. Cases with previous suprapubic surgery, stones of more than 1 cm in diameter, multiple bladder or urethral stone, anterior urethral stones and cases with neurological or anatomical abnormalities were excluded from our study. The bladder was filled and punctured suprapubically by an artery forceps under the vision of the pediatric cystoscopy then the stone is completely crushed. All intraoperative and postoperative complications were recorded. The stone-free rate status was evaluated 2 weeks postoperatively using plain X-ray/ultrasonography.
Results
All cases were successful, and the stones were completely crushed to smaller insignificant fragments in a single session. No intraoperative bladder perforation or bleeding was recorded. The mean operative time was 12.5 min (ranging from 9 to 17 min). There were no postoperative complications apart from 2 cases of persistent suprapubic leakage postoperatively for 24 h and the leakage stopped after 48 h with the insertion of 8 Fr Foley catheter. In all cases, no significant stone fragments were found 2 weeks postoperatively.
Conclusion
Our technique for management of pediatric vesical and posterior urethral stone less than 1 cm is an easy and safe with no intraoperative or postoperative significant complications.
Similar content being viewed by others
References
Holman E, Khan AM, Flasko T et al (2004) Endoscopic management of pediatric urolithiasis in a developing country. Urology 63:159–162
Choong S, Whitfield H, Duffy P et al (2000) The management of paediatric urolithiasis. BJU Int 86:857–860
Demirel F, Çakan M, Yalcinkaya F et al (2006) Percutaneous suprapubic cystolithotripsy approach: for whom? why? J Endourol 6:429–431
Schwentner C, Oswald J, Lunacek A et al (2005) Giant cysteine stone in an infant bladder with no evidence of cystinuria—valence of possible pathomechanisms. Urol Int 75:285–287
Papatsoris AG, Varkarakis I, Dellis A et al (2006) Bladder lithiasis: from open surgery to lithotripsy. Urol Res 34:163–179
Zargooshi J (2001) Open stone surgery in children: is it justified in the era of minimally invasive therapies? BJU Int 88:928–931
Rizvi SA, Naqvi SA, Hussain Z et al (2003) Management of pediatric urolithiasis in Pakistan: experience with 1,440 children. J Urol 169:634–637
Al-Marhoon MS, Sarhan OM, Awad BA et al (2009) Comparison of endourological and open cystolithotomy in the management of bladder stones in children. J Urol 181:2684–2688
Isen K, Em S, Kilic V et al (2008) Management of bladder stones with pneumatic lithotripsy by using a ureteroscope in children. J Endourol 5:1037–1040
Gan W, Guo H, Yang R et al (2009) Minimally invasive percutaneous cystolithotomy: an effective treatment for bladder stones in infants aged <1 year. BJU Int 106:275–277
Salah MA, Holman E, Khan AM et al (2005) Percutaneous cystolithotomy for pediatric endemic bladder stone: experience with 155 cases from 2 developing countries. J Pediatr Surg 40:1628–1631
Tugcu V, Polat H, Ozbay B et al (2009) Percutaneous versus transurethral cystolithotripsy. J Endourol 23:237–241
Agrawal MS, Aron M, Goyal J et al (1999) Percutaneous suprapubic cystolithotripsy for vesical calculi in children. J Endourol 3:173–175
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gamal, W., Eldahshoury, M., Hussein, M. et al. Cystoscopically guided percutaneous suprapubic cystolitholapaxy in children. Int Urol Nephrol 45, 933–937 (2013). https://doi.org/10.1007/s11255-013-0465-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-013-0465-4