Almesned Razan Khalid, Binjawhar Abdulrahman, Altaweel Waleed, Alomar Mohammed
Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Urol Ann. 2025 Jan-Mar;17(1):64-67. doi: 10.4103/ua.ua_83_24. Epub 2025 Jan 18.
Calculous formation is a well-known complication of lower urinary tract reconstruction using an intestinal segment. Special considerations are required as access to the reconstructed bladder is complicated. To date, a standard strategy is yet to be accepted.
This study aims to investigate the efficiency and safety of percutaneous cystolitholapaxy (PCCL) access.
This was a retrospective analysis of patients with reconstructed lower urinary tract who developed bladder stones and were treated with PCCL.
Seven patients underwent a total of nine PCCLs between 2019 and 2023. Sone burden ranged from 4 to 10 cm. No intraoperative complications were faced. Three patients had residual stone fragments < 7 mm in size. Suprapubic catheter was removed between days 0 and 3 postoperative. Cystostomy was left to close spontaneously, none of the patients developed peritoneal leak after removal. Patients with Mitrofanoff channel reported no leak or compromise to the continued mechanism. Predominant stone composition was magnesium ammonium phosphate (struvite) in seven cases.
In our experience, PCCL accessing through bowel segment without tract closure in reconstructed bladder is a reliable and safe approach. When it comes to our patient selection, no limitations to this approach have been identified.
结石形成是使用肠段进行下尿路重建的一种众所周知的并发症。由于进入重建膀胱的操作复杂，需要特殊考虑。迄今为止，尚未有被接受的标准策略。
本研究旨在探讨经皮膀胱碎石取石术（PCCL）通路的有效性和安全性。
这是一项对患有膀胱结石并接受PCCL治疗的下尿路重建患者的回顾性分析。
2019年至2023年间，7例患者共接受了9次PCCL治疗。结石负荷范围为4至10厘米。未出现术中并发症。3例患者残留结石碎片尺寸小于7毫米。耻骨上导尿管在术后0至3天拔除。膀胱造瘘口自行闭合，拔除后无一例患者发生腹膜漏。有米氏通道的患者未报告持续机制出现漏液或功能受损。7例患者结石的主要成分是磷酸镁铵（鸟粪石）。
根据我们的经验，在重建膀胱中经肠段进行PCCL且不封闭通道是一种可靠且安全的方法。就我们的患者选择而言，尚未发现该方法存在限制。
