Percutaneous cystolithotomy for pediatric endemic bladder stone: experience with 155 cases from 2 developing countries.
OBJECTIVE
The aim of this study was to evaluate retrospectively our experience with percutaneous cystolithotomy (PCCL) in children having endemic urinary bladder stones.


METHODS
Between January 1993 and June 2003, 155 children younger than 14 years underwent PCCL. The patients' age ranged from 8 months to 14 years (average, 4.5 years). One hundred fifteen patients (74.2%) were 5 years or younger, 31 patients (20%) were between 6 and 10 years, and 9 patients (5.8%) were between 11 and 14 years. There were 153 boys and 2 girls. The stone size ranged from 0.7 to 4 (average, 2.3) cm. The procedure was done under general anesthesia. Dilation of the tract was made under fluoroscopy. The instrument was the adult 26F nephroscope, the same that is used for percutaneous nephrolithotomy. Ultrasound disintegration was needed for stones larger than 1 cm. Suprapubic catheter was left for 24 hours. Urethral catheter was kept for 48 hours.


RESULTS
All patients became stone-free. The average operating time was 20 (5-60) minutes. The average hospital stay was 2.7 (2-5) days. No any severe intra- or postoperative complication was observed. The nucleus and/or the main component of the stones were ammonium acid urate in 144 patients (93%).


CONCLUSIONS
Based on our experience, we can conclude that PCCL is a safe and effective method for treatment of endemic bladder stones in children. It reduces morbidity and hospital stay, and thus the cost of treatment. Our series proves the nutritional etiology of the endemic pediatric bladder stones.
Salah
Morshed A
MA
Department of Urology, Medical and Health Science Center, University of Debrecen, Debrecen 4032, Hungary. morshed@jaguar.unideb.hu
Holman
Endre
E
Khan
A Munim
AM
Toth
Csaba
C
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D012189:Retrospective Studies; D001744:Urinary Bladder Calculi / Q000453:epidemiology / Q000601:surgery*; D015006:Yemen / Q000453:epidemiology