Objectives: To assess the efficacy and safety of percutaneous cystolithalopexy in children under 5 years of age Study design: Retrospective study Place: Department of Paediatric Urology Institute of Kidney Diseases Hayat Abad Peshawar Methodology: Retrospective descriptive study was conducted in Institute of kidney diseases Peshawar between Jan 2020 and January 2022. After applying the inclusion and exclusion criteria all patients in the mentioned period were include in his study. Results were inferred as frequency and percentages. Results: Without observing any difference for age and gender 100% clearance was achieved in all patients with the most prominent complication being supra pubic catheter leakage which was treated conservatively. Conclusions: Percutaneous cystolithalopexy is safe and efficient for the management of bladder stone under 5 years Keywords: Bladder Calculi, Percutaneous Cystolithalopexy, Urolithiasis, Lithiasis

Objectives: To assess the safety and effectiveness of mini-percutaneous nephrolithotomy (PCNL) in paediatric age patients. Materials and Methods: This descriptive case series study was conducted in the Department of Paediatric Urology, Institute of Kidney Diseases, Hayatabad Medical Complex, Peshawar, Pakistan from June 2017 to June 2020. Children < 14 years, diagnosed with renal stone > 1cm in size on non-contrast CT of Kidney Ureter and Urinary Bladder (KUB) and having negative urine culture were enrolled in the study. Patients having abnormal renal functions and bleeding diathesis were omitted from the study. Informed written consent was taken from the parents of all the children. Children with no stone fragments in the kidney or ipsilateral ureter on non-contrast CT KUB at one month were labelled as stone free. Results: A total of 213 children who underwent mini-PCNL were analyzed. 130 (61.03%) of the stones were 10-15 mm and 83 (38.97%) were > 15 mm in size. The mean operation time was 56.02 + 7.82 (40-81) minutes .The mean hospital stay was 2.22 + 0.67 (2-7) days. The mean decrease in haemoglobin was 1.30 + 0.67 (0.2-4.0) gm/dL. No major intraoperative complication was observed. 24 (11.27%) of the patients developed post-operative complications including 10.33 % minor and 0.94 % major complications which were statistically insignificant. As a monotherapy mini-PCNL achieved complete stone clearance at one month in 191 (89.67%) of the patients. Retreatment was required in 22 (10.33%) of the patients including extracorporeal shock wave lithotripsy (ESWL) in 7 (3.29%), ureteroscopy (URS) in 10 (4.69%) and Re-PCNL in 5 (2.35%) patients. Conclusion: This study concludes that mini-PCNL in a paediatric population is safe and effective for renal stones > 10 mm with acceptable stone clearance and complications. Keywords: Kidney calculi, Pediatrics, Percutaneous, Children, Urolithiasis

Introduction: Bladder stone treatment in children is evolving rapidly. Vesicolithotomy has now been rarely used except in very large stone and even larger stones are treated with percutaneous cystolithotripsy, which is still more invasive compared with transurethral cystolithotripsy. We have evaluated a series of 150 case of bladder stone in children with this minimal approach through natural orifice i.e. urethra to assess its feasibility, efficacy and complications. Objective: To assess the safety and efficacy of transurethral cystolithotripsy for bladder stone in pediatric population. Material and Methods: This study was conducted in the Institute of Kidney Diseases and Transplant HMC Peshawar Pakistan from Jan 2020 to Apr 2022. A series of 150 patients were assessed with a mean age of 7.5+-2.9 years and mean stone size of 11.2+-3.6mm. Mean operative time was 28.1+- 5.8 minutes, mean hospital stay was 0.2+-1. A total of 89.33% of were treated as a day case. Two patients (1.3%) needed re-cystolithotripsy while in none of the cases were converted to open or PCCL. Postoperatively 16 (10.67%) patients developed Clavien grade 1 complications and 2(1.33%) patients developed Clavien grade III complication. Conclusion: Trans-urethral cystolithotripsy is feasible and effective in pediatric population with acceptable clearance rate and low grade complication for stones up to 20 mm. However comparison with open method is needed. Keywords: Bladder stone, Trans-urethral, Cystolithotripsy.

Background: Purpose of the study is to evaluate the safety and efficacy of full length Percutaneous (PCN) versus cut PCN in pediatric population. PCN is performed to establish temporary drainage of obstructed or dilated renal system till definitive management. PCN is well established procedure which is performed under deep sedation, local anesthesia or general anesthesia ultrasound guided or fluoroscopic guided. Methodology: Randomized controlled study carried out in 200 children in the department of urology, Institute of Kidney Disease, Hayatabad Peshawar Pakistan from Jan 2020 to Apr 2022 and analysis was done by using SPSS version 20 to know the efficacy of the cut versus full length PCN in children. Results: This study was carried out over 200 children using cut and full length percutaneous nephrostomy tube, 100 in each group. This study includes 119 males and 81 females of mean age 5.49+ 3.127 years. The cause of obstruction was 61% PUJ obstruction, 55% VUR, 47% obstructed stone and other causes in 37%patients. Effective decompression of hydronephrosis were noted in 89% in cut length vs 82% in full end PCN (p<0.1%). Skin inflammation of 100% with cut end PCN and 20% with full length, 96% of PCN didn’t show any inflammation (p<0.001%). Dislodgment of PCN was noted multiple time in 54%, two times in 38% and 7% in full length PCN where as it is noted two times in 47% and one times in 45% in cut PCN(p<0.001%). PCN exchange was needed multiple times in 51% patients and two times in 39% patients in full length PCN where it was needed two times in 41% and one time in 50% patients in CUT PCN arm (0.001%). Conclusion: This study concludes that cut end PCN is more effective in term of PCN exchange and dislodgement but having more skin inflammation as compared to full length PCN