Management of bladder stones: the move towards non-invasive treatment

Deswanto, Isaac Ardianson; Basukarno, Ari; Birowo, Ponco; Rasyid, Nur

doi:10.13181/mji.v26i2.1602

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…In the last few years, transurethral lithotripsy has become an alternative method to open cystolithotomy (8)(9)(10). However, the adoption of this approach in the pediatric patients is limited by the narrow caliber of the urethra in children (11).…”

Section: Discussionmentioning

confidence: 99%

“…In developed countries the main components of BS are struvite or calcium oxalate dihydrate, while in developing countries the main component is ammonium acid urate (5)(6)(7). In the last few years, transurethral lithotripsy has become an alternative method to open cystolithotomy (8)(9)(10). However, the adoption of this approach in the pediatric patients is limited by the narrow caliber of the urethra in children (11).…”

Section: Introductionmentioning

confidence: 99%

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Minimally Invasive Management of Bladder Stones in Children

et al. 2021

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Background: Bladder stones (BS) are rare in children. Minimally invasive surgery (MIS) seems to be nowadays the procedure of choice to treat pediatric patients with BS. This study aimed to analyze retrospectively our experience with percutaneous cystolithotomy, endourological treatment with Holmium laser and robotic cystolithotomy in children with BS.Methods: We retrospectively analyzed the data of 13 children (eight boys and five girls) with BS who were treated at our centers between July 2013 and July 2020. The patients received three different MIS procedures for stones removal: five underwent robotic cystolithotomy, five underwent endourological treatment and three received percutaneous cystolithotomy (PCCL). We preferentially adopted endourological approach for stones <10 mm, percutaneous approach between 2014 and 2016 and robotic approach since 2016 for larger stones.Results: Mean patients' age at the time of diagnosis was 13 years (range 5–18). Ten/13 patients (76.9%) had primary BS and 3/13 patients (23.1%) had secondary BS. Mean stone size was 18.8 mm (range 7–50). In all cases the stones were removed successfully. One Clavien II post-operative complication occurred following PCCL (33.3%). All the procedures were completed without conversions. Operative time ranged between 40 and 90 min (mean 66) with no significant difference between the three methods (p = 0.8). Indwelling bladder catheter duration was significantly longer after PCCL (mean 72 h) compared with robotic and endourological approaches (mean 15.6 h) (p = 0.001). Hospitalization was significantly longer after PCCL (mean 7.6 days) compared with the other two approaches (mean 4.7 days) (p = 0.001). The endourological approach was the most cost-effective method compared with the other two approaches (p = 0.001).Conclusions: Minimally invasive management of bladder stones in children was safe and effective. Endourological management was the most cost-effective method, allowing a shorter hospital stay compared with the other procedures but it was mainly indicated for smaller stones with a diameter < 10 mm. Based upon our preliminary results, robotic surgery seemed to be a feasible treatment option for BS larger than 15–20 mm. It allowed to remove the big stones without crushing them with a safe and easy closure of the bladder wall thanks to the easy suturing provided by the Robot technology.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Management of Bladder Stones in Children

et al. 2021

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“…Delayed complications include urethral stricture formation. 13 Transurethral fragmentation of bladder stones using pneumatic intra corporal lithotripsy method is a minimal invasive method which can be used for small size stones but not suitable for large size stones. 14 Due to prolong operative time and urethral manipulation with instruments it is not a treatment of choice now.…”

Section: Discussionmentioning

confidence: 99%

Vesical stone management by percutaneous cystolitholapexy versus open vesicolithotomy among children.

Bhatti

Khuhro

Brohi

2021

TPMJ

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Objective: To compare outcomes, safety and complications of vesical stone management among children by open vesicolithotomy versus percutaneous cystolitholapaxy. Study Design: Cross Sectional study. Setting: Department of Urology and Kidney Transplantation Pir Abdul Qadir Institute of Medical Sciences Gambat. Period: July 2020 to December 2020. Material & Methods: Children with vesical stone, having age 1-12 years and fulfilling inclusion criteria were selected for this study. Total 50 cases were selected using non-probability consecutive sampling technique. Patients were divided into two groups Group-A and Group-B on the basis of given treatment each group containing 25 cases. Patients in Group-A were underwent open vesicolithotomy and those in group-B were underwent percutaneous cystolitholapexy. Procedure was done under general anesthesia. Alken metallic dilators were used for the dilatation of tract. Adult nephroscope with 24Fr sheath was used. Postoperative outcomes of both methods were compared with each other. Pneumatic fragmentation was used to break stones > 1.5cm in size. Results: Total 50 cases were studied, 25 cases in each group-A and group-B. Stone size was 1-3 cm in both groups. Age range of the patients was 1-12 years with mean age of 4.25 ± 1.4 years. Mean hospital stay was 2.6 days in group-A and 1.3 days in group-B. Mean requirement of analgesia (ketorolac) was 30.2mg in group-A and 14.8mg in group-B. Most common postoperative complication was fever observed in 28% cases in group-A and hematuria observed in 24% cases in group-B. Conclusion: Percutaneous cystolitholapexy is a minimal invasive procedure suitable among children with high success rate and minimum complications like postoperative fever, hematuria, urinary leakage and pain.

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“…Batu kandung kemih merupakan salah satu jenis penyakit batu saluran kemih yang jarang ditemukan, dimana angka kejadiannya berkisar 5%. [1][2][3][4][5][6] Penatalaksanaan pada kasus batu kandung kemih didasarkan beberapa pertimbangan, salah satunya adalah ukuran dari batu tersebut. Pada kasus batu dengan ukuran besar, pengangkatan batu dengan prosedur bedah terbuka sering menjadi pilihan utama, karena menjanjikan batu akan terangkat 100%.…”

Section: Pendahuluanunclassified

“…Sedangkan batu kandung kemih sekunder pada daerah non endemis biasanya ditemukan pada orang dewasa dan selalu berhubungan dengan suatu proses penyakit yang menyebabkan terjadinya stasis urine, misalnya akibat BPH atau striktur uretra, sehingga terjadi kristalisasi dan terbentuk batu. 1,5,6 Untuk batu migran, biasanya batu berasal dari traktus urinarius bagian atas, yaitu ginjal dan ureter, yang kemudian pindah ke kandung kemih.…”

Section: Pembahasanunclassified

Tindakan Litotripsi Transuretra Pada Batu Kandung Kemih Ukuran Besar Di RS Harapan Keluarga Mataram

Maulana¹,

Nandana²,

Salatiah³

2018

JKU

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Latar belakang: Angka kejadian batu buli cukup tinggi di negara berkembang, dengan banyak kejadian batu berukuran besar. Pada kasus ini ditemukan batu buli dengan ukuran >3 cm dan berhasil dilakukan pengambilan batu tanpa melalui prosedur bedah terbuka. Tujuan: Untuk melaporkan satu kasus tindakan litotripsi transuretra pada pasien batu kandung kemih dengan ukuran besar (> 3 cm). Tindakan litotripsi jarang dilakukan pada kasus ini, karena biasanya harus dilakukan pembedahan untuk mengangkat batu dengan ukuran besar. Metode: Suatu kasus, seorang laki-laki usia 58 tahun mengeluh kencing tidak lancar dan nyeri sejak 16 tahun yang lalu. Kencing terkadang berwana merah. Pemeriksaan fisik dalam batas normal. Dilakukan pemeriksaan penunjang berupa pemeriksaan laboratorium, BNO, dan USG urologi. Kemudian dilakukan operasi pengangkatan batu dengan prosedur litotripsi transuretra. Hasil: Pada BNO didapatkan gambaran batu buli ukuran 3,9 x 2,71 cm. Kemudian dilakukan tindakan litotripsi transuretra selama 1 jam dan batu buli-buli berhasil dikeluarkan dalam bentuk pecahan kecil. Pasien pulang membawa kateter dan beberapa hari kemudian kateternya dilepas. Pasien bisa kencing spontan lancar. Kesimpulan: Tindakan litotripsi pada kasus batu buli ukuran besar jarang dilakukan, terutama di NTB. Pada kasus ini, dengan tindakan litotripsi alhamdulillaah batu berhasil dikeluarkan dalam pecahan-pecahan kecil. Tidak ditemukan komplikasi pada pasien ini.

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Management of bladder stones: the move towards non-invasive treatment

Cited by 6 publications

References 23 publications

Minimally Invasive Management of Bladder Stones in Children

Minimally Invasive Management of Bladder Stones in Children

Vesical stone management by percutaneous cystolitholapexy versus open vesicolithotomy among children.

Tindakan Litotripsi Transuretra Pada Batu Kandung Kemih Ukuran Besar Di RS Harapan Keluarga Mataram

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