Technique, complications, and outcomes of pediatric urolithiasis management at a tertiary care hospital: evolving paradigms over the last 15 years

Yadav, Priyank; Madhavan, Kumar; Syal, Sarita; Farooq, Aadil; Srivastava, Aneesh; Ansari, M.S.

doi:10.1016/j.jpurol.2019.09.011

Cited by 11 publications

(7 citation statements)

References 44 publications

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“…Analyzing the international literature, there are several techniques to treat BS using open cystolithotomy, endourology, percutaneous techniques and more recently robotic surgery (21)(22)(23)(24)(25). Strong scientific evidence regarding the optimal approach to BS in the pediatric population is still lacking, but the various endourological approaches have become the mainstay of surgical management of patients presenting with this rare pathology.…”

Section: Discussionmentioning

confidence: 99%

“…PCCL has been demonstrated to be adequate and rapid in managing BS in children. However, PCCL has a high complication rate in children (25). For instance, leakage of urine, fistula formation or acute abdomen secondary to intra-peritoneal bladder perforation, have been reported postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…The problem with PCCL is that, using this technique, it's not easy to close the bladder through a 3-4 cm incision and sometimes there are leaks that facilitate formation of a fistula. Moreover, there are complications linked to the technique itself, such as bladder perforation or bleeding (25). At beginning of our experience with PCCL, we experienced a urinary leak in one patient, who required a prolonged bladder catheterization.…”

Section: Discussionmentioning

confidence: 99%

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Minimally Invasive Management of Bladder Stones in Children

et al. 2021

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Background: Bladder stones (BS) are rare in children. Minimally invasive surgery (MIS) seems to be nowadays the procedure of choice to treat pediatric patients with BS. This study aimed to analyze retrospectively our experience with percutaneous cystolithotomy, endourological treatment with Holmium laser and robotic cystolithotomy in children with BS.Methods: We retrospectively analyzed the data of 13 children (eight boys and five girls) with BS who were treated at our centers between July 2013 and July 2020. The patients received three different MIS procedures for stones removal: five underwent robotic cystolithotomy, five underwent endourological treatment and three received percutaneous cystolithotomy (PCCL). We preferentially adopted endourological approach for stones <10 mm, percutaneous approach between 2014 and 2016 and robotic approach since 2016 for larger stones.Results: Mean patients' age at the time of diagnosis was 13 years (range 5–18). Ten/13 patients (76.9%) had primary BS and 3/13 patients (23.1%) had secondary BS. Mean stone size was 18.8 mm (range 7–50). In all cases the stones were removed successfully. One Clavien II post-operative complication occurred following PCCL (33.3%). All the procedures were completed without conversions. Operative time ranged between 40 and 90 min (mean 66) with no significant difference between the three methods (p = 0.8). Indwelling bladder catheter duration was significantly longer after PCCL (mean 72 h) compared with robotic and endourological approaches (mean 15.6 h) (p = 0.001). Hospitalization was significantly longer after PCCL (mean 7.6 days) compared with the other two approaches (mean 4.7 days) (p = 0.001). The endourological approach was the most cost-effective method compared with the other two approaches (p = 0.001).Conclusions: Minimally invasive management of bladder stones in children was safe and effective. Endourological management was the most cost-effective method, allowing a shorter hospital stay compared with the other procedures but it was mainly indicated for smaller stones with a diameter < 10 mm. Based upon our preliminary results, robotic surgery seemed to be a feasible treatment option for BS larger than 15–20 mm. It allowed to remove the big stones without crushing them with a safe and easy closure of the bladder wall thanks to the easy suturing provided by the Robot technology.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Minimally Invasive Management of Bladder Stones in Children

et al. 2021

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“…Another article compared the outcomes for pediatric of renal stones from 2003-2010 and from 2010 to 2018 in India 20 . Out of the total pediatric population presented till 2010, 115 children received conventional PCNL, while out of the total patients who presented after 2010, 129 children underwent mini-PCNL and nine participants had standard PCNL.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Patient Outcomes of Urolithiasis and Ureteral Stones in a Pediatric Population: A Prospective Analysis from a Tertiary Care Centre

Brohi¹,

Bajwa²,

Sohail³

et al. 2022

PJMHS

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Objectives: This study was aimed to highlight the clinical characteristics and patient outcome associated with urolithiasis and ureteral stones in a pediatric urological department. Methodology: A descriptive study was conducted between February 2021 and April 2022 at Gambat Medical Hospital, Khairpur, Sindh. All patients between the ages of 2 years and 17 years presented at the outpatients department and inpatients department for the management of urolithiasis were included in the study. All patients with congenital renal abnormalities were excluded from the study. Sociodemographic and clinical characteristics, treatment/management offered, outcome, and early postoperative complications were documented. All data was analyzed using SPSS version 24. Results: During the study period of one year, a total of 72 pediatric patients were diagnosed with urolithiasis. A mean age of 8.33 (5.6) years was noted with 26 (36.1%) female patients and 46 (63.8%) male patients. 20 (27.8%) patients had left renal stones. Two of these patients had right ureteral stones as well. These patients were managed with right ureterolithotomy and double J-stent placement. There were ten patients with bilateral renal stones. Two patients with a right vesicoureteric junction (VUJ) stone were treated with ureteroscopy (URS). In six (8.3%) cases, residual stones were noted. Conclusion: The majority of the pediatric population had solitary right renal stones and the most common procedure performed at our centre was pyelolithotomy followed by nephrectomy. The majority had a good postoperative outcome. Keywords: Renal Colic, Pyelolithotomy, Percutaneous Nephrolithotomy (PCNL), PUJO, J-stent placement

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“…Based on (Yadav et al, 2019) that had complete clearance of pediatric bladder stone using the percutaneous approach in their study. Similar with (Salah et al, 2005).…”

Section: Presenting Features Includementioning

confidence: 99%

Pediatric Bladder Stone in Secondary Hospital Care Setting: A Case Report

Rizkyansyah¹,

Ambeng²

2021

JRSSEM

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Bladder Stone is a rare disease accounting for 5% of all urinary calculi. It more common in middle and low-income countries due to nutritional obstacles, water sanitation, and warm climates. Prompt diagnosis and management of pediatric bladder stones are essential for preventing recurrence stones and improving quality of life. It has several surgical approaches. The objective is reporting a child with a bladder stone that came to secondary hospital setting and the best management based on it. This report is qualitative observational study. Material came from direct interview and from medical record. The stone successfully managed with open cystolithotomy.

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Technique, complications, and outcomes of pediatric urolithiasis management at a tertiary care hospital: evolving paradigms over the last 15 years

Cited by 11 publications

References 44 publications

Minimally Invasive Management of Bladder Stones in Children

Minimally Invasive Management of Bladder Stones in Children

Clinical Characteristics and Patient Outcomes of Urolithiasis and Ureteral Stones in a Pediatric Population: A Prospective Analysis from a Tertiary Care Centre

Pediatric Bladder Stone in Secondary Hospital Care Setting: A Case Report

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