title: Transurethral Holmium Laser Cystolithotripsy in Children: Single Center Experience.
abstract: OBJECTIVE
  To evaluate prospectively safety and efficacy of transurethral cystolithotripsy (CL) in children using holmium:yttrium-aluminum-garnet (Ho:YAG) laser. This is important in developing countries, because the risk of bladder stones in children is high. Open cystolithotomy (OC) was the main line of treatment. A gradual shift has occurred toward endourologic treatment after improvement of pediatric endoscopes.
  
  
  METHODS
  Between January 2010 and May 2011, 33 children <12 years old with vesical calculi were treated. Children with orthopedic deformities, urethral stricture, history of urethral operations or bladder reconstruction, or stones >4 cm were excluded. Cystoscopies were performed under general anesthesia using 9 to 11F cystoscopes. Stones were completely fragmented under video guidance. Ho:YAG was applied at a power of 30 W.
  
  
  RESULTS
  Median age was 3 years (0.5-11). Mean stone size was 2.02±0.82 cm (1-4 cm). Mean operative duration was 31.21 minutes (20-50). All children were discharged within 24 hours. A single operative session was performed for each patient. No complications were detected. After a mean follow-up of 16.87±4.08 months, all children were stone free, without development of any urethral stricture or recurrence of stones. Operative duration was significantly longer in stones >20 mm (P<0.001).
  
  
  CONCLUSIONS
  Ho:YAG laser CL is a safe and successful minimally invasive treatment option for bladder stones in children. Success rate was 100% without development of any complications or recurrence.
authors.affiliation: Department of Urology, Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University , Cairo, Egypt .
authors.forename: Waseem
authors.initials: W
authors.lastname: Aboulela
authors.affiliation: Department of Urology, Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University , Cairo, Egypt .
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: ElSheemy
authors.affiliation: Department of Urology, Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University , Cairo, Egypt .
authors.forename: Ahmed I
authors.initials: AI
authors.lastname: Shoukry
authors.affiliation: Department of Urology, Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University , Cairo, Egypt .
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Shouman
authors.affiliation: Department of Urology, Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University , Cairo, Egypt .
authors.forename: Ahmed
authors.initials: A
authors.lastname: ElShenoufy
authors.affiliation: Department of Urology, Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University , Cairo, Egypt .
authors.forename: Kareem
authors.initials: K
authors.lastname: Daw
authors.affiliation: Department of Urology, Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University , Cairo, Egypt .
authors.forename: Hany A
authors.initials: HA
authors.lastname: Morsi
authors.affiliation: Department of Urology, Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University , Cairo, Egypt .
authors.forename: Hesham
authors.initials: H
authors.lastname: Badawy
mesh_terms: D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D004534:Egypt; D006801:Humans; D007223:Infant; D053844:Lasers, Solid-State; D017602:Lithotripsy, Laser / Q000379:methods*; D008297:Male; D010351:Patient Discharge; D011446:Prospective Studies; D012008:Recurrence; D012449:Safety; D016896:Treatment Outcome; D001744:Urinary Bladder Calculi / Q000601:surgery*