Aboulela Waseem, ElSheemy Mohammed S, Shoukry Ahmed I, Shouman Ahmed M, ElShenoufy Ahmed, Daw Kareem, Morsi Hany A, Badawy Hesham
Department of Urology, Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University , Cairo, Egypt .
J Endourol. 2015 Jun;29(6):661-5. doi: 10.1089/end.2014.0636. Epub 2015 Mar 31.
To evaluate prospectively safety and efficacy of transurethral cystolithotripsy (CL) in children using holmium:yttrium-aluminum-garnet (Ho:YAG) laser. This is important in developing countries, because the risk of bladder stones in children is high. Open cystolithotomy (OC) was the main line of treatment. A gradual shift has occurred toward endourologic treatment after improvement of pediatric endoscopes.
Between January 2010 and May 2011, 33 children <12 years old with vesical calculi were treated. Children with orthopedic deformities, urethral stricture, history of urethral operations or bladder reconstruction, or stones >4 cm were excluded. Cystoscopies were performed under general anesthesia using 9 to 11F cystoscopes. Stones were completely fragmented under video guidance. Ho:YAG was applied at a power of 30 W.
Median age was 3 years (0.5-11). Mean stone size was 2.02±0.82 cm (1-4 cm). Mean operative duration was 31.21 minutes (20-50). All children were discharged within 24 hours. A single operative session was performed for each patient. No complications were detected. After a mean follow-up of 16.87±4.08 months, all children were stone free, without development of any urethral stricture or recurrence of stones. Operative duration was significantly longer in stones >20 mm (P<0.001).
Ho:YAG laser CL is a safe and successful minimally invasive treatment option for bladder stones in children. Success rate was 100% without development of any complications or recurrence.
前瞻性评估使用钬：钇铝石榴石（Ho:YAG）激光进行经尿道膀胱结石碎石术（CL）在儿童中的安全性和有效性。这在发展中国家很重要，因为儿童膀胱结石的风险很高。开放性膀胱切开取石术（OC）是主要的治疗方法。随着儿科内镜的改进，治疗已逐渐转向腔内泌尿外科治疗。
2010年1月至2011年5月，对33例12岁以下的膀胱结石患儿进行了治疗。排除有骨科畸形、尿道狭窄、尿道手术或膀胱重建史或结石>4 cm的患儿。在全身麻醉下使用9至11F膀胱镜进行膀胱镜检查。在视频引导下将结石完全粉碎。以30 W的功率应用Ho:YAG。
中位年龄为3岁（0.5 - 11岁）。平均结石大小为2.02±0.82 cm（1 - 4 cm）。平均手术时间为31.21分钟（20 - 50分钟）。所有患儿均在24小时内出院。每位患者均进行了单次手术。未发现并发症。平均随访16.87±4.08个月后,所有患儿结石均消失，未出现任何尿道狭窄或结石复发。结石>20 mm的患儿手术时间明显更长（P<0.001）。
Ho:YAG激光CL是治疗儿童膀胱结石的一种安全且成功的微创治疗选择。成功率为100%，未出现任何并发症或复发。
