Suprapubic cystolitholapaxy: a variable option for paediatric bladder stones

ABSTRACT

To assess the complications of suprapubic cystolitholapaxy as an alternative procedure for bladder stones in pediatric age group. Prospective analystical study. This study was carried out in Department of Urology, University of Medical and health sciences Jamshoro from May 2006 to December 2010. this study consisted of 148 patients admitted though the outpatient department of Liaquat University Hospital Jamshoro/Hyderabad. All patients underwent base line and specific investigations especially ultrasound of abdomen and pelvis as diagnostic modality for assessment of bladder stones. Inclusion criteria were all these patients who after counseling for this study and gave written consent parents. Irrespective of their sex and age < 12 years of age presented with bladder stone of < 3cm. Exclusion criteria included were patients having history of previous surgery, posterior urethral valves, stricture urethra and stone > 3 cm were excluded from the study. Results were prepared with help of tables and graphs. Data was analyzed through SPSS software. 148 patients, 124 [83.78%] were boys and 24 [16.21%] were girls with ratio 5.11 respectively. Mean age of the patients was 5.3 years with range from 1 to 11 years. Twelve [8.1%] patients presented with retention of urine due to impacted stone at bladder neck or prostatic urethra while 16 [10.81%] patients had coexisting renal stones. The mean size of the stones was 1.9 cm with range from 1.1 to 2.8 cm. Total operative time ranged from 25 to 40 minutes. Patients were discharged after observing first void on 2[nd] post-operative day 136 [91.89%] while twelve [8.11%] patients required further stay due to either suprapubic urinary leakage in 5[3.37%] or urinary retention in 7[4.72%] patients. Percutaneous suprapubic cystolitholapaxy is safe and cost-effective alternative to open surgery in children with vesical calculi