title: Cystoscopically guided percutaneous suprapubic cystolitholapaxy in children.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of endoscopically guided percutaneous suprapubic artery forceps litholapaxy for pediatric vesical and posterior urethral stone <1 cm in diameter.
  
  
  METHODS
  A retrospective series study of 73 children (68 boys and 5 girls) with vesical and urethral stones less than 1 cm in diameter with an average age of 3.5 years (range 1-9 years) were included in this study. Cases with previous suprapubic surgery, stones of more than 1 cm in diameter, multiple bladder or urethral stone, anterior urethral stones and cases with neurological or anatomical abnormalities were excluded from our study. The bladder was filled and punctured suprapubically by an artery forceps under the vision of the pediatric cystoscopy then the stone is completely crushed. All intraoperative and postoperative complications were recorded. The stone-free rate status was evaluated 2 weeks postoperatively using plain X-ray/ultrasonography.
  
  
  RESULTS
  All cases were successful, and the stones were completely crushed to smaller insignificant fragments in a single session. No intraoperative bladder perforation or bleeding was recorded. The mean operative time was 12.5 min (ranging from 9 to 17 min). There were no postoperative complications apart from 2 cases of persistent suprapubic leakage postoperatively for 24 h and the leakage stopped after 48 h with the insertion of 8 Fr Foley catheter. In all cases, no significant stone fragments were found 2 weeks postoperatively.
  
  
  CONCLUSIONS
  Our technique for management of pediatric vesical and posterior urethral stone less than 1 cm is an easy and safe with no intraoperative or postoperative significant complications.
authors.affiliation: Department of Urology, Sohag University, Sohâg, Egypt. wael_saad_el_dien@hotmail.com
authors.forename: Wael
authors.initials: W
authors.lastname: Gamal
authors.forename: Mohamed
authors.initials: M
authors.lastname: Eldahshoury
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hussein
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hammady
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003558:Cystoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D061214:Patient Safety; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000175:diagnosis / Q000628:therapy*; D001744:Urinary Bladder Calculi / Q000175:diagnosis / Q000628:therapy*