Percutaneous cystolithotripsy of bladder stones in children: A case series, an experience from a tertiary hospital

Abstract

Urinary calculus is more commonly known in infants, and the urinary bladder is the most common location in the lower urinary tract for stone formation. There are three basic types of bladder calculus: Primary idiopathic/endemic, secondary, and migrant. The standard treatment of bladder calculus is open cystolithotomy or transurethral cystolitholapaxy. However, the use of a percutaneous approach has been promoted. We performed percutaneous cystolithotripsy with urethrocystoscopy guidance in children with bladder stones. The procedure was done without any ultrasound or fluoroscopic guidance. In children who required percutaneous cystolithotripsy with urethrocystoscopy guidance, we documented four cases of bladder stones. The diagnoses were made based on anamnesis, ultrasonography, physical examination, and X-ray imaging. In all patients, the operation was successful, and intraoperative results showed a single stone in each of the three patients and two stones in the same patient. This report aims to define the surgical challenges presented by bladder stones and the multidisciplinary approach needed to deal with them. Under ultrasound or fluoroscopic guidance, we performed percutaneous cystolithotripsy in children. The percutaneous cystolithotripsy was the most frequent outpatient treatment. The bladder was first filled with contrast material or water. A Foley catheter was inserted in the urethra and left for a period of 3–5 days. The rectus fascia defect was closed using the 2-0 vicryl suture. Percutaneous suprapubic lithotripsy is a safe and successful procedure for treating bladder stones in children. It is fast and linked to negligible complications.

Bladder concretion against the background of staged treatment of exstrophy (clinical case)

“…(2022 г.) до 50% пациентов с реконструированным мочевым пузырем подвергаются камнеобразованию в течение жизни [1]. Осипов И.Б.…”

“…Методы удаления конкрементов мочевого пузыря разнообразны, стандартными и общепринятыми методиками является открытая цистолитотомия при крупных конкрементах и трансуретральная цистолитотрипсия с применением различных видов энергий, однако в детском возрасте она имеет ряд ограничений технического и анатомического характера; альтернативными доступами к конкременту является перкутанный чрезкожный или доступ через аппендикостому [1]. Последний наиболее физиологичен.…”

“…экстрофии [2,6]. Лечение в ряде случаев затруднительно и требует применения ряда инвазивных, в т. ч. и «открытых» оперативных вмешательств [1,4]. Результаты лечения его часто остаются неудовлетворительными [5].…”