Palmer L S, Franco I, Reda E F, Kogan S J, Levitt S B
Section of Pediatric Urology, Albert Einstein College of Medicine, Bronx, New York.
Urology. 1994 Dec;44(6):902-4. doi: 10.1016/s0090-4295(94)80179-7.
We sought to evaluate the effectiveness and utility of an endoscopic approach to calculi that develop in the bladders of children following augmentation cystoplasty. In addition, we aimed to determine the indications for open vesicolithotomy.
We reviewed our experience between 1981 and 1993 with 26 children who formed bladder calculi following augmentation cystoplasty. Data were retrieved retrospectively with respect to management approach and outcome.
Nineteen cases were managed cystoscopically using simple extraction and/or electrohydraulic lithotripsy; 3 cases required open vesicolithotomy and four calculi passed spontaneously. Complete stone extraction was achieved after a single endoscopic treatment in every case approached in this fashion. Every patient resumed preoperative voiding patterns and there were no infections, strictures, or other complications. Calculi reformed in 4 patients and were successfully managed endoscopically.
An endoscopic approach to bladder calculi is a safe and effective method of managing this increasingly prevalent problem in children following augmentation cystoplasty even in the presence of a reconstructed bladder neck. Open vesicolithotomy should be reserved for the very large stone burden.
我们试图评估内镜治疗在膀胱扩大成形术后儿童膀胱内形成结石的有效性和实用性。此外，我们旨在确定开放性膀胱结石切除术的适应证。
我们回顾了1981年至1993年间26例膀胱扩大成形术后形成膀胱结石的儿童的治疗经验。回顾性收集关于治疗方法和结果的数据。
19例采用膀胱镜下单纯取石和/或液电碎石治疗；3例需要行开放性膀胱结石切除术，4例结石自行排出。采用这种方式处理的每例患者经单次内镜治疗后均实现结石完全取出。所有患者均恢复术前排尿模式，且无感染、狭窄或其他并发症。4例患者结石复发，经内镜治疗成功处理。
对于膀胱扩大成形术后儿童日益普遍的膀胱结石问题，即使存在重建的膀胱颈，内镜治疗也是一种安全有效的方法。开放性膀胱结石切除术应仅用于结石负荷非常大的情况。
