Minimally invasive percutaneous cystolithotomy: an effective treatment for bladder stones in infants aged <1 year.

Abstract

To present our experience with minimally invasive percutaneous cystolithotomy (MPCCL) for the treatment of bladder stones in infants aged <1 year. From 1 January 2003 to 31 October 2008, 15 boys with a mean (range) age of 8.2 (3.0-11.5) months underwent MPCCL. The mean (range) stone diameter was 1.4 (0.9-2.2) cm. Ten infants had a solitary stone while five had more than one stone. MPCCLs were performed under general anaesthesia. A 16 F peel-away sheath was introduced as a working tract after dilatation with percutaneous nephrolithotomy dilators (8-16 F) under fluoroscopic control. After dilatation, an 8-9.8 F ureteroscope was introduced into the bladder, and the stones were fragmented with a shock wave lithotriptor. After the MPCCL, a 14 F suprapubic catheter was left in situ and fixed to the skin, and removed 1 or 2 days after MPCCL. The urethral catheter was removed 2 or 3 days after MPCCL. The absence of stone fragments on plain X-ray/ultrasonography was considered as a 'stone-free' status. All infants were stone-free after one MPCCL; no recurrent stones developed. The mean MPCCL procedure time was 25 min and intraoperative blood loss was scant. Perioperative complications were few. The mean hospital stay was 2.8 days. MPCCL is a safe and effective treatment option for bladder stones in infants, reducing postoperative complications and shortening hospital stay.