Abdul Rasheed Shaikh, Ghulam Shabir Shaikh, Abdul Hameed Shaikh, Abdul Haleem Shaikh, Nisar Ahmed Shaikh.
Endoscopic treatment of vesical calculi in children.
Rawal Med J Jan ;35(1):15-8.

Objective: To determine the out come of endoscopic treatment of vesical calculi in children and its long- term effect on urethra. Patients and Methods: This quasi-experimental study included five hundred patients seen at Almas Medical center and City Hospital Larkana from January, 2000 to December, 2009. After necessary investigations and diagnosis, they were divided into two groups on the basis of having either small or large size stone in urinary bladder. A pediatric cystoscope of 8Fr size with angled eyepiece and straight working channel and Swiss lithoclast lithotripter were used for the procedure. Results: Out of 500 children, Group 1 comprised of 350 (70%) cases who had radiological measurement of stone size less than 2.0 cm whereas, Group 2 comprised of 150 (30%) cases and had stone 2.0 to 3.0 cm in size. The mean age was 4.6 year. Male to female ratio was 9:1. The stones were disintegrated and removed successfully in all the cases. Postoperative recovery was uneventful and statistically no significant difference was found between two groups. The mean operative time was 25 minutes (range 15 to 35 minutes) and 45 minutes (range 30 to 55 minutes) in group 1 and group 2 respectively and difference was statistically significant (P<0.05). Postoperative Foley`s catheter of 8 or 10 Fr was left only in 175 (35%) cases. Operative complications like urethral and bladder bleeding, and infection occurred in 37 (7.5%), 30 (6%) and 18 (3.5%) cases respectively. The mean hospitalization time was 1.2 days (range 1-3 days), and the mean follow-up was 1.3 months (range 1-6 months). Recurrent vesical calculus and stricture urethra was observed only in 15 (3%) and two (0.4%) cases respectively. Conclusion: Cystolithotripsy with Swiss Lithoclast is highly effective, safe and associated with few short-term and long-term complications. We recommend it as a primary first-line treatment modality for up to 3.0 cm vesical calculi in children. (Rawal Med J 2010;35: 15-18).

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