Abstract
Amaç: Çalışmamızda mesane taşı olan çocuk hastalarda açık sistolitotomi ve intrakorporeal sistolitotripsi deneyimlerimizin sonuçlarını değerlendirmeyi amaçladık.
Gereç ve Yöntemler: 2007-2016 tarihleri arasında toplam 23 hasta kliniğimizde mesane taşı nedeni ile tedavi edildi. Tedavide sistoskopi ile basket kateterle taşın çıkarılması, lazer ile transüretral veya perkütan sistolitotripsi ve açık sistolitotomi yöntemleri tercih edildi. Hastalar tercih edilen operasyon tekniği, taş yükü ve operasyon sonrası görülen komplikasyonlar açısından birbirleri ile karşılaştırıldı.
Bulgular: Hastaların üçü kız, 20’si erkekti, yaşları 1 ila 16 yaş arasındaydı. Taş boyutlarının en küçük 5, en büyük 50 mm olduğu kaydedildi. Toplam 7 hastada transüretral sistolitotrpsi, 4 hastada perkütan sistolitotripsi ve 8 hastada açık sistolitotomi tercih edildi. Dört hastada taşlar ise basket kateter ile transüretral olarak çıkarıldı. Yirmi (%87) hastada herhangi bir komplikasyon görülmedi. Komplikasyon görülen hastaların birisi taş çıkarılırken üretra mukozasında laserasyon gelişen hastaydı. Diğer iki hasta ise transüretral sistolitotripsi operasyonu sonrası rezidü fragmante taşlar nedeniyle alt üriner sistem obstrüksiyonu gelişen hastalardı. Açık sistolitotomi tercih edilen hastaların taş boyutu ortalamasının 22.6±12 mm, diğer tekniklerin tercih edildiği hastaların taş boyutlarının ortalamasının ise 16 ± 9.04 mm olduğu görüldü.
Sonuç: Mesane taşı olan çocuk hastalarda taş boyutu 2 cm üzerinde ise açık sistolitotomi yöntemi tercih edilmesinin diğer yöntemlere göre daha efektif olduğunu düşünmekteyiz.
Keywords
References
- 1.Edvardsson V, Elidottir H, Indridason OS, Palsson R. High incidence of kidney stones in Icelandic children. Pediatr Nephrol 2005;20:940-4.
- 2. Van Dervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, et al. Urolithiasis in pediatric patients: A single center study of incidence, clinical presentation and outcome. J Urol 2007;177:2300–5.
- 3. Lopez M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol 2010;25:49–59.
- 4. Bichler KH, Strohmaier WL, Korn S. Urolithiasis in childhood. Monatsschr Kinderheild 1985;133:256-66.
- 5. Johnson O. Vesical calculus in Ethiopian children. Ethiop Med J 1995;33:31-5.
- 6. Eckstein HB. Endemic urinary lithiasis in Turkish children: A clinical study of 119 cases. Arch Dis Child 1961;36:137–45.
- 7. Alpay H, Ozen A, Gokce I, Biykli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. Pediatr Nephrol 2009;24:2203–9.
- 8. Sofer M, Kaver I, Greenstein A, Yosef YB, Mabjeesh NJ, Chen J, et al. Refinements in treatment of large bladder calculi: Simultaneous percutaneous suprapubic and transurethral cystolithotripsy. Urology 2004;64:651-4.
- 9. Phillippou P, Moraltis K, Masood J, Junald I, Buchholz N. The management bladder lithiasis in the modern era of endourology. Urology 2012;79:980-6.
- 10. Dhaballa JV, Jaln N, Kumar V, Nelivigi GG. Modified technique of percutaneous cystolithotripsy using a new instrument combined single step trocar dilator with self retaining adjustable access sheath. Urology 2011;77:1304-7.
- 11. Salah MA, Holman E, Khan AM, Toth C. Percutaneous cystolithotomy for pediatric endemic bladder stone: Experience with 155 cases from 2 developing countries. J Pediatr Surg 2005;40:1628-31.
- 12. Aboulela W, El Sheemy MS, Shoukry AI, Shouman AM, El Shenoufy A, Daw K, et al. Transurethral holmium laser cystolithotripsy in children: Single center experience. J Endourology 2015;29:661–5.
- 13. Al-Marhoon MS, Sarhan OM, Awad BA, Helmy T, Ghali A, Dawaba MS. Comparison of endourological and open cystolithotomy in the management of bladder stones in children. J Urol 2009;181:2684-8.
- 14. Naqvi SAA, Rizvi SAH, Shahjehan S. Analysis of urinary calculi by chemical methods. J Pak Med Assoc 1984;34:147-53.
- 15. Rizvi SAH, Sultan S, Zafar MN, Ahmed B, Faiq SM, Hossain KZ, et al. Evaluation of children with urolithiasis. Indian J Urol 2007;23:420–7.
- 16. Bakane BC, Nagtilak SB, Patil B. Urolithiasis: A tribal scenario. Indian J Pediatr 1999;66:863–5.
- 17. Ece A, Ozdemir E, Gurkan F, Dokucu AI, Akdeniz O. Characteristics of pediatric urolithiasis in South-East Anatolia. Int J Urol 2000;7:330-4.
- 18. Schwartz BF, Stoller ML. The vesical calculus. Urol Clin North Am 2000;27:333-46.
- 19. Ozokutan BH, Kucukaydin M, Gunduz Z, Kabaklioglu M, Okur H, Turan C. Urolithiasis in childhood. Pediatr Surg Int 2000;16:60-3.
- 20. Khosa AS, Hussain M, Hussain M. Safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in children. J Park Med Assoc 2012;62:1297-300.
Abstract
Objective: The aim of this study was to retrospectively evaluate our experience on open cystolithotomy and intracorporeal cystolithotripsy in children with bladder stones.
Material and Methods: A total of 23 children with bladder stones were treated at our center between 2007 and 2016. Transurethral removal with basket catheter, transurethral cystolithotripsy / percutaneous cystolithotripsy with laser or open cystolithotomy approaches were preferred. The patients were evaluated according to the operation technique, stone burden, and complications, and compared with each other in terms of these criteria.
Results: Three girls and 20 boys, ranging in age from 1 to 16 years were evaluated. Stone sizes ranged from 5 to 50 mm. We preferred transurethral cystolithotripsy in 7 patients, percutaneous cystolithotripsy in 4 patients, open cystolithotomy in 8 patients and transurethral removal with basket catheter in 4 patients. Twenty (87%) patients had no complications. Complications occurred in three patient consisting of a mucosal laceration in one patient and lower urinary tract obstruction due to residual stones in the postoperative period in two patients. The average stone size was 22.6±12 mm in all patients who underwent open cystolithotomy and 16 ± 9.04 mm in patients where the other methods were used.
Conclusion: We believe that open cystolithotomy is the most effective treatment method, especially for stones greater than 2 cm.
Keywords
References
- 1.Edvardsson V, Elidottir H, Indridason OS, Palsson R. High incidence of kidney stones in Icelandic children. Pediatr Nephrol 2005;20:940-4.
- 2. Van Dervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, et al. Urolithiasis in pediatric patients: A single center study of incidence, clinical presentation and outcome. J Urol 2007;177:2300–5.
- 3. Lopez M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol 2010;25:49–59.
- 4. Bichler KH, Strohmaier WL, Korn S. Urolithiasis in childhood. Monatsschr Kinderheild 1985;133:256-66.
- 5. Johnson O. Vesical calculus in Ethiopian children. Ethiop Med J 1995;33:31-5.
- 6. Eckstein HB. Endemic urinary lithiasis in Turkish children: A clinical study of 119 cases. Arch Dis Child 1961;36:137–45.
- 7. Alpay H, Ozen A, Gokce I, Biykli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. Pediatr Nephrol 2009;24:2203–9.
- 8. Sofer M, Kaver I, Greenstein A, Yosef YB, Mabjeesh NJ, Chen J, et al. Refinements in treatment of large bladder calculi: Simultaneous percutaneous suprapubic and transurethral cystolithotripsy. Urology 2004;64:651-4.
- 9. Phillippou P, Moraltis K, Masood J, Junald I, Buchholz N. The management bladder lithiasis in the modern era of endourology. Urology 2012;79:980-6.
- 10. Dhaballa JV, Jaln N, Kumar V, Nelivigi GG. Modified technique of percutaneous cystolithotripsy using a new instrument combined single step trocar dilator with self retaining adjustable access sheath. Urology 2011;77:1304-7.
- 11. Salah MA, Holman E, Khan AM, Toth C. Percutaneous cystolithotomy for pediatric endemic bladder stone: Experience with 155 cases from 2 developing countries. J Pediatr Surg 2005;40:1628-31.
- 12. Aboulela W, El Sheemy MS, Shoukry AI, Shouman AM, El Shenoufy A, Daw K, et al. Transurethral holmium laser cystolithotripsy in children: Single center experience. J Endourology 2015;29:661–5.
- 13. Al-Marhoon MS, Sarhan OM, Awad BA, Helmy T, Ghali A, Dawaba MS. Comparison of endourological and open cystolithotomy in the management of bladder stones in children. J Urol 2009;181:2684-8.
- 14. Naqvi SAA, Rizvi SAH, Shahjehan S. Analysis of urinary calculi by chemical methods. J Pak Med Assoc 1984;34:147-53.
- 15. Rizvi SAH, Sultan S, Zafar MN, Ahmed B, Faiq SM, Hossain KZ, et al. Evaluation of children with urolithiasis. Indian J Urol 2007;23:420–7.
- 16. Bakane BC, Nagtilak SB, Patil B. Urolithiasis: A tribal scenario. Indian J Pediatr 1999;66:863–5.
- 17. Ece A, Ozdemir E, Gurkan F, Dokucu AI, Akdeniz O. Characteristics of pediatric urolithiasis in South-East Anatolia. Int J Urol 2000;7:330-4.
- 18. Schwartz BF, Stoller ML. The vesical calculus. Urol Clin North Am 2000;27:333-46.
- 19. Ozokutan BH, Kucukaydin M, Gunduz Z, Kabaklioglu M, Okur H, Turan C. Urolithiasis in childhood. Pediatr Surg Int 2000;16:60-3.
- 20. Khosa AS, Hussain M, Hussain M. Safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in children. J Park Med Assoc 2012;62:1297-300.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Publication Date | March 21, 2019 |
| Submission Date | November 7, 2017 |
| Published in Issue | Year 2019 Volume: 13 Issue: 1 |
The publication language of Turkish Journal of Pediatric Disease is English.
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