No abstract

Background: Primary bladder stones are common among children from developing countries but may be difficult to cure. Transurethral cystolithotripsy, open cystolithotomy, and shock wave lithotripsy are the treatment modalities for vesical calculi in children. Transurethral lithotripsy is less efficient in children because of the small caliber of the urethra. PCCL is a less intrusive and efficient procedure for removing bladder stones in pediatric patients. Objectives: The objective of the study was to determine the safety and efficacy of PCCL in children with bladder stones in third-world nations. Materials and Methods: There was a search for( PCCL) in pediatric individuals diagnosed with vesical calculus. 90% male and 10% female total of 120 patients enrolled in the single-center trial at the Department of Pediatric Urology at the Institute of Kidney Diseases between January 2021 to January 2022. The surgery was performed under a general anesthetic. After a thorough inspection, a suprapubic puncture of the lower urinary tract (by cystoscopy) was done. The tract was only dilated up to 14 Fr. The stone was fragmented using pneumatic lithotripsy after passing the nephroscope. After 36 hours per urethral catheter was removed. Results: In this study, the mean age of the patients was 4.2.14 years. The majority of patients were kids. The average gem was 9.3 millimeters in diameter. Successful stone fragmentation and retrieval took place in an average of 40 min. The only major problems seen during or after surgery were hematuria, infection, and moderate mucosal injury; all three were managed conservatively. In 108 out of 120 cases (90%), ammonium acid urate was found to be the primary constituent of the stones and the core. Conclusion: The success rate of percutaneous cystolithotripsy in the treatment of bladder stones in children is higher, and it is ready for immediate use. The operation is quick and causes minimal discomfort. Keywords: Effectiveness, Percutaneous , Cystolithotripsy, Vesical Calculus, Children

Aim: This study aims to characterize the clinical manifestations, location of the obstruction, and surgical intervention results of individuals with obstructive urethral stones. Study design: A single-center study Place and Duration: IKD Peshawar, Departboyst of Urology, from January 1, 2020, to January 1, 2021. Methods: 124 obstructive urethral stones were treated at IKD Peshawar. 4 to 14-year-old patients Obstructive urethral stones were treated surgically by removing the stone from the external urethral meatus (stone retrieval) with or without Meatotomy, retrograde manipulation (push back), and then cystolithoclasty or cystolitholapaxy, depending on the stone's position and size. Results: The mean age was 04±12.14 was between 10 and 12 years old. A total of 118 boys (98%), together with 06 girls (02%), were aged 13 and above. Sixty boys had stones in the proximal urethra (prostatic and membranous) or bulbar urethra, while 24 boys had stones in the external urethral meatus. Stones were found in the external urethral meatus of 60 boys individuals. Conclusion: For the most part, obstructive urethral stones may be managed with endoscopic therapy, but in certain situations, a minor operation like a meatotomy is necessary. Keywords: urethral obstruction, managment t, outcome, surgery, intervention

To compare the successful outcome of flap versus no-flap in O'Conor & Sokol technique for simple vesicovaginal fistula (VVF) repair. Methods: This quasi-experimental study was conducted in department of Urology, Institute of Kidney Diseases, Hayatabad Medical Complex Peshawar, Pakistan from March 2015 to December 2019. During this study period, 64 eligible patients, selected through non-probability convenient sampling technique were assigned to two Groups. Group A included 34 patients who underwent VVF repair through O'Conor & Sokol technique without interposition flap while Group B comprised 30 patients with VVF repair with interposition flap. Patient getting completely dry with no urinary incontinence at primary endpoint of 6 months was labelled as successful outcome. All the pre-operative, per-operative and postoperative data was collected on structured proforma and analyzed on SPSS version-21. Results: The mean age of the patient was 33.8±7.8 years in group A and 35±6.3 years in group B. About 76.5% (n=26/34) patients in group A and 80% (n=24/30) patients in Group B developed VVF due to obstetrical trauma. Overall, O'Conor and Sokol technique of VVF repair was successful by curing urinary incontinence in 95.3% (n=61/64) patients. Successful outcome for O'Conor & Sokol technique was achieved in 94.1% (n=32/94) patients in Group A and 96% (n=29/30) patients in Group B, at 6 months of follow-up (p>0.05). Conclusion: There is no significant difference between interposition flap and noflap in outcome of simple VVF repair through O'Conor & Sokol technique. The decision of interposition can be individualized depending upon preference of surgeon.