Ismy Jufriady, Asnafi Arie, Pratama Rovy
Department of Urology, Faculty of Medicine, Zainoel Abidin Hospital, Universitas Syiah Kuala, Banda Aceh, Indonesia.
Department of Urology, Faculty of Medicine, Hasan Sadikin General Hospital, Universitas Padjajaran, Bandung, Indonesia.
Urol Ann. 2022 Jan-Mar;14(1):85-88. doi: 10.4103/UA.UA_177_20. Epub 2022 Jan 20.
Urinary calculus is more commonly known in infants, and the urinary bladder is the most common location in the lower urinary tract for stone formation. There are three basic types of bladder calculus: Primary idiopathic/endemic, secondary, and migrant. The standard treatment of bladder calculus is open cystolithotomy or transurethral cystolitholapaxy. However, the use of a percutaneous approach has been promoted. We performed percutaneous cystolithotripsy with urethrocystoscopy guidance in children with bladder stones. The procedure was done without any ultrasound or fluoroscopic guidance. In children who required percutaneous cystolithotripsy with urethrocystoscopy guidance, we documented four cases of bladder stones. The diagnoses were made based on anamnesis, ultrasonography, physical examination, and X-ray imaging. In all patients, the operation was successful, and intraoperative results showed a single stone in each of the three patients and two stones in the same patient. This report aims to define the surgical challenges presented by bladder stones and the multidisciplinary approach needed to deal with them. Under ultrasound or fluoroscopic guidance, we performed percutaneous cystolithotripsy in children. The percutaneous cystolithotripsy was the most frequent outpatient treatment. The bladder was first filled with contrast material or water. A Foley catheter was inserted in the urethra and left for a period of 3-5 days. The rectus fascia defect was closed using the 2-0 vicryl suture. Percutaneous suprapubic lithotripsy is a safe and successful procedure for treating bladder stones in children. It is fast and linked to negligible complications.
小儿膀胱结石较为常见,膀胱是下尿路结石形成最常见的部位。膀胱结石有三种基本类型:原发性特发性/地方性、继发性和迁移性。膀胱结石的标准治疗方法是开放性膀胱切开取石术或经尿道膀胱碎石术。然而,经皮治疗方法已得到推广。我们在膀胱结石患儿中采用尿道膀胱镜引导下经皮膀胱碎石术。该手术无需任何超声或荧光透视引导。在需要尿道膀胱镜引导下经皮膀胱碎石术的患儿中,我们记录了4例膀胱结石病例。诊断依据病史、超声检查、体格检查和X线成像做出。所有患者手术均成功,术中结果显示,3例患者各有1枚结石,1例患者有2枚结石。本报告旨在明确膀胱结石带来的手术挑战以及应对这些挑战所需的多学科方法。在超声或荧光透视引导下,我们对患儿实施了经皮膀胱碎石术。经皮膀胱碎石术是治疗小儿膀胱结石最常用的门诊治疗方法。首先向膀胱内注入造影剂或水。经尿道插入Foley导尿管并留置3 - 5天。用2 - 0可吸收缝线关闭腹直肌筋膜缺损。经皮耻骨上膀胱碎石术是治疗小儿膀胱结石的一种安全、成功且快速的手术,并发症极少。