Micropercutaneous cystolithotomy in children: our experience with the transillumination technique.
OBJECTIVE
We present our experience with micropercutaneous cystolithotripsy (mPCCL) using transillumination-guided access in children with bladder stones and evaluate the safety and efficacy of this procedure.


METHODS
Twelve children who underwent mPCCL for bladder stone removal in our department between January 2011 and September 2013 were included in this study. Percutaneous access was performed using the transillumination technique. The chief complaint, age and sex of the patients, stone size, operative time, complications, stone-free rate, and stone composition as determined by radiography diffraction analysis were recorded.


RESULTS
The mean age of the patients was 2.6 (1-7) years. One out of 12 patients was a girl. The mean stone size was 14 mm (7-32 mm). The mean mPCCL procedure time was 38.7 (15-65) minutes. The mean hospital stay was 1.4 (0.5-4) days. The stone-free rate after one mPCCL intervention was 91.6% and increased to 100% after two sessions of mPCCL. The notable complications were transient macroscopic hematuria in one patient, acute urinary retention in one patient, and the need for a second session of mPCCL in another patient. The stones were composed of calcium oxalate (3), ammonium acid urate (1), calcium phosphate (1), cystine (1), struvite (1), and unknown (5).


CONCLUSIONS
Transillumination-guided mPCCL is a safe and effective technique, does not require the use of ionizing radiation, is technically easy, and is a minimally invasive alternative for the management of bladder stones. It has many advantages, especially in pediatric patients, such as decreased urethral injury, no need for postoperative catheter insertion in most cases, and shorter operative time.
Department of Urology, Dicle University, Faculty of Medicine , Diyarbakır, Turkey .
Mehmet Nuri
MN
Bodakci
Ahmet Ali
AA
Sancaktutar
Mansur
M
Dağgulli
Namık Kemal
NK
Hatipoglu
Haluk
H
Söylemez
Necmettin
N
Penbegul
Murat
M
Atar
Yasar
Y
Bozkurt
D002130:Calcium Phosphates / Q000737:chemistry; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D003553:Cystine / Q000737:chemistry; D005260:Female; D006417:Hematuria / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007902:Length of Stay; D017616:Magnesium Compounds / Q000737:chemistry; D008297:Male; D061646:Operative Time; D010710:Phosphates / Q000737:chemistry; D011183:Postoperative Complications; D000069877:Struvite; D014172:Transillumination / Q000379:methods*; D014527:Uric Acid / Q000737:chemistry; D001744:Urinary Bladder Calculi / Q000737:chemistry / Q000601:surgery*
D002130:Calcium Phosphates; D017616:Magnesium Compounds; D010710:Phosphates; D014527:Uric Acid; D003553:Cystine; C020243:calcium phosphate; D000069877:Struvite