Catheter‐less Suprapubic Cystolithotomy in Children

Abstract

Bladder stones in children are common in developing countries and the procedure of choice for their removal is suprapubic cystolithotomy. It is standard practice to drain the bladder for a few days post-operatively to prevent urinary leakage. We have observed that, if the bladder is closed meticulously in 2 layers, bladder drainage by means of a catheter is not required. We have analysed 86 children treated by suprapubic cystolithotomy without a catheter. Size of the stones and intra-operative findings were noted and it was found that 85% of the patients had an excellent result; 10% had a satisfactory result and 4.7% were unsatisfactory. The advantages of the procedure and selection of the patients are discussed.

Catheterless and drainless open suprapubic cystolithotomy in children: a safe procedure

“…There are potential hazards following catheterisations, such as infection, stricture [3], etc. Sabnis et al [2] have opined that a catheter in the bladder post-operatively may not be necessary in children for ensuring a good healing. However, they prophylactically inserted a retropubic drain in all children.…”

“…This is the recommended technique to ensure a leak proof closure [1]. This type of water tight closure assured us of a good bladder healing and allowed us to dispense with a retropubic drain [in contrast to the protocol of Sabnis et al [2] where the bladder was closed in two layers using fine absorbable suture (inner mucosal continuous and outer muscle layer with interrupted sutures) and retropubic drain was used]. The good results in our initial ten children of Group 2 encouraged us to continue with the same protocol in the remaining study subjects too.…”

“…Sabnis et al [2] described their experience of catheterless suprapubic cystolithotomy in 86 children over a period of 8 years. They employed prevesical drainage in all cases and closed the bladder in two layers using inner mucosal continuous and outer muscle layer with interrupted sutures.…”