Isen Kenan, Em Suat, Kilic Vehbi, Utku Vedat, Bogatekin Salih, Ergin Huseyin
Department of Urology, State Hospital of Diyarbakir, Diyarbakir, Turkey.
J Endourol. 2008 May;22(5):1037-40. doi: 10.1089/end.2007.0342.
To evaluate the effectiveness and safety of pneumatic lithotripsy by using a ureteroscope to treat bladder stones in children.
Twenty-seven boys presenting with bladder stones underwent transurethral cystolithotripsy. The indication for transurethral cystolithotripsy was stone size <or=2 cm. A 8/9.8F Wolf semi-rigid ureteroscope or 9.5F Storz ureteroscope and a pneumatic lithotripter were used for stone fragmentation in all patients.
All patients were stone-free at 2 weeks postoperatively. The mean age was 7.6 years (range 3-14 years), and the mean stone size was 14 mm (range 8-20 mm). The operating time was 22 minutes (range 10-46 minutes). The mean hospitalization time was 1.2 days (range 1-3 days), and the mean follow-up was 13 months (range 1-32 months). No complications due to pneumatic lithotripsy other than mild hematuria were observed intraoperatively. Stone forceps were used to retrieve large stone fragments (5-6 mm in size) in 10 (37%) of the patients. After the operation, acute retention was observed in 2 (7.4%) of the patients due to failure of fragments to pass through the urethra. A second procedure was performed on these patients. Fever was observed in 2 (7.4%) of patients. No long-term complications or stone recurrences were seen in any patient.
Pneumatic lithotripsy using a ureteroscope appears to be an effective and safe treatment for bladder stones in children. It is minimally invasive and involves reduced hospital stay and overall cost. However, it can cause some problems in terms of spontaneous passage. Thus it may be used as an alternative treatment option in selected patients.
评估使用输尿管镜进行气压弹道碎石术治疗儿童膀胱结石的有效性和安全性。
27例患有膀胱结石的男孩接受了经尿道膀胱结石碎石术。经尿道膀胱结石碎石术的指征为结石大小≤2 cm。所有患者均使用8/9.8F Wolf半硬性输尿管镜或9.5F Storz输尿管镜及气压弹道碎石机进行结石破碎。
所有患者术后2周结石均清除。平均年龄为7.6岁（范围3 - 14岁），平均结石大小为14 mm（范围8 - 20 mm）。手术时间为22分钟（范围10 - 46分钟）。平均住院时间为1.2天（范围1 - 3天），平均随访时间为13个月（范围1 - 32个月）。术中除轻度血尿外，未观察到气压弹道碎石术引起的其他并发症。10例（37%）患者使用结石钳取出大的结石碎片（大小为5 - 6 mm）。术后，2例（7.4%）患者因碎片未能通过尿道而出现急性尿潴留，对这些患者进行了二次手术。2例（7.4%）患者出现发热。所有患者均未出现长期并发症或结石复发。
使用输尿管镜进行气压弹道碎石术似乎是治疗儿童膀胱结石的一种有效且安全的方法。它具有微创性，可缩短住院时间并降低总体费用。然而，在结石自然排出方面可能会出现一些问题。因此，它可作为特定患者的替代治疗选择。
