Management of bladder stones with pneumatic lithotripsy using a ureteroscope in children.
OBJECTIVE
To evaluate the effectiveness and safety of pneumatic lithotripsy by using a ureteroscope to treat bladder stones in children.


METHODS
Twenty-seven boys presenting with bladder stones underwent transurethral cystolithotripsy. The indication for transurethral cystolithotripsy was stone size <or=2 cm. A 8/9.8F Wolf semi-rigid ureteroscope or 9.5F Storz ureteroscope and a pneumatic lithotripter were used for stone fragmentation in all patients.


RESULTS
All patients were stone-free at 2 weeks postoperatively. The mean age was 7.6 years (range 3-14 years), and the mean stone size was 14 mm (range 8-20 mm). The operating time was 22 minutes (range 10-46 minutes). The mean hospitalization time was 1.2 days (range 1-3 days), and the mean follow-up was 13 months (range 1-32 months). No complications due to pneumatic lithotripsy other than mild hematuria were observed intraoperatively. Stone forceps were used to retrieve large stone fragments (5-6 mm in size) in 10 (37%) of the patients. After the operation, acute retention was observed in 2 (7.4%) of the patients due to failure of fragments to pass through the urethra. A second procedure was performed on these patients. Fever was observed in 2 (7.4%) of patients. No long-term complications or stone recurrences were seen in any patient.


CONCLUSIONS
Pneumatic lithotripsy using a ureteroscope appears to be an effective and safe treatment for bladder stones in children. It is minimally invasive and involves reduced hospital stay and overall cost. However, it can cause some problems in terms of spontaneous passage. Thus it may be used as an alternative treatment option in selected patients.
Isen
Kenan
K
Department of Urology, State Hospital of Diyarbakir, Diyarbakir, Turkey. kenanisen@hotmail.com
Em
Suat
S
Kilic
Vehbi
V
Utku
Vedat
V
Bogatekin
Salih
S
Ergin
Huseyin
H
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D013997:Time Factors; D020709:Ureteroscopes; D001744:Urinary Bladder Calculi / Q000628:therapy*; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy