ROLE OF PNEUMATIC LITHOTRIPSY IN PAEDIATRIC BLADDER STONES - “I WILL NOT CUT UPON STONE!”

• Main Authors: Liaqat Ali, Saima Ali, Shafieullah Khan, Nasir Orakzai
• Format: Article
• Language: English
• Published: Khyber Medical University 2014-04-01
• Series: Khyber Medical University Journal
• Online Access: https://www.kmuj.kmu.edu.pk/article/view/12837
• ISSN: 2305-2643; 2305-2651

Objective: To study the effectiveness and safety of pneumatic lithotripsy in paediatric bladder stone disease. Methodology: This descriptive study was conducted at department of urology at institute of kidney diseases Hayatabad Peshawar from 01-01-2009 till 30-03-2013 on 120 children with bladder stones, selected by nonprobability convenient sampling technique. Stones in the bladder were fragmented by pneumatic lithotripsy using straight working channel paediatric cystoscope. All the pre-operative, per-operative and postoperative data was recorded on structured Proforma and was analyzed on SPSS version 17. Results: The mean age of the patients was 6.2+2.03 years (range 3-12 years). The mean stone size was 14.1+3.30 mm. Forty-five (37.5%) patients presented with crying while micturation and pulling of the penis, 40 (33.3%) patients with recurrent febrile urinary tract infection and 35 (29.2%) patients with acute urinary retention. Stone was completely fragmented in 97.5% (n=117) cases. Mean operative time was 27.5+5.48 min (range 15-40 min) and the mean hospital stay was 1.23+0.65 days (Range 1-3 days). Bladders stone were successfully fragmented with pneumatic lithoclast in 97.5% (n=117) of cases. The patients with failed procedure (2.5%) were subjected to formal vesicolithotomy in same setting. All the patients were completely stone free by 3rd postoperative day. Early complications were recorded in 12.5% (n=15/120) cases including mild haematuria (5%), pain in urethra (4.2%), febrile UTI (2.5%) and unable to void (0.8%). There was no urethral stricture recorded during 18 months of follow up. Conclusions: Pneumatic lithotripsy is minimally invasive, effective and safe modality in management of paediatric bladder stone.