title: Percutaneous suprapubic stone extraction for posterior urethral stones in children: efficacy and safety.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of percutaneous suprapubic stone extraction (PSPSE) for pediatric posterior urethral stones.
  
  
  METHODS
  Between July 2007 and June 2010, 54 boys presenting with acute urinary retention due to posterior urethral stones underwent PSPSE. Patients were a mean age of 66.4 months (range, 8-180 months). The stone size was 0.7-1.9 cm. Patients were placed under general anesthesia, and a 7F urethroscope was used to pushback the stone to the bladder. A 3-mm suprapubic puncture with a scalpel was performed, followed by insertion of a straight narrow hemostat through the puncture aided with cystoscopic guidance. The stone was grasped with the hemostat in its narrowest diameter and was extracted percutaneously or crushed if friable. The suprapubic puncture was closed with a single 4-0 Vicryl (Ethicon) suture.
  
  
  RESULTS
  Intact stone retrieval was achieved in 45 patients, and the stone was crushed into minute fragments in 9 patients. Intraperitoneal extravasation developed in 1 patient that required open surgical intervention. Mean operative time was 22 minutes. Patients were monitored for up to 17 months, with complete resolution of symptoms and stone clearance.
  
  
  CONCLUSIONS
  PSPSE provides a minimally invasive approach for the extraction of urethral and bladder stones in the pediatric population. The use of a straight hemostat for suprapubic stone extraction or crushing is a good alternative to suprapubic tract dilation, with minimal morbidity.
authors.affiliation: Department of Urology, Assiut University, Assiut, Egypt. assafwat@gmail.com
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Safwat
authors.forename: Diaa A
authors.initials: DA
authors.lastname: Hameed
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Elgammal
authors.forename: Yasser M
authors.initials: YM
authors.lastname: Abdelsalam
authors.forename: Ahmad
authors.initials: A
authors.lastname: Abolyosr
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D061646:Operative Time; D014522:Urethral Diseases / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014545:Urinary Calculi / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects