Percutaneous use of Stone Punch in the Management of Vesical Calculi in Children: A New Treatment Modality

Abstract

Background: To evaluate the efficacy, safety and results of a newer technique, using Mauermayer stone punch for percutaneous bladder stone removal in children. Material and Methods: It was a prospective study from November 2000 to November 2004, in the Department of Urology, Peoples Medical college hospital Nawabshah, Pakistan. One hundred and thirty children having vesical calculi of various sizes were included in this study. The procedure is based on principal of percutaneous removal of bladder stones, using ordinary trocar cannula under video-cystoscopic visualization and Stone punch to extract/fragment the stones. These children were evaluated by detailed history, clinical examination, ultrasonography, Radiography of urinary tract, urine routine examination, urine culture and blood urea. These patients, who were otherwise candidates for open cystolithotomy, were treated percutaneously using suprapubicapproach. Results: Satisfactory results were obtained in almost all cases having solitary and multiple stones. In selected cases urethral damage, operating time, hospital stay and cost can be decreased to minimum with this simple technique. Conclusion: This study shows that suprapubic percutaneous route can be employed as an alternative procedure to previously reported different percutaneous modalities where percutaneous nephrolithotomy instruments, laparoscopic instruments, percutaneous vacuum sheaths and other trocar and stone forceps have been utilized for removal of vesical calculi.