To compare between transurethral cystolithotripsy and percutaneous cystolithotripsy in the management of bladder stones in male children regarding efficacy and morbidity.Patients and methods
One hundred boys younger than 14 years with a single bladder or urethral stone less than 30 mm were randomized into two equal groups. Initial diagnostic urethro-cystoscopy and push back of urethral stones were done for patients in both groups. Patients in group A had transurethral cystolithotripsy, while those in group B had percutaneous cystolithotripsy through a 20-Fr sheath using a 12-Fr nephroscope. The two groups were compared regarding preoperative criteria, intraoperative details and postoperative outcomes.Results
The patients in this study had a median (range) age of 36 (4—144) months and a median (range) stone size of 10 (5—26) mm. There was no statistically significant difference between the two groups regarding preoperative criteria. The assigned procedure was successful in 48(96%) patients in group A and 49 (98%) patients in group B (p = 1). Complications were encountered in 11(22%) patients in group A and five (10%) patients in group B (p = 0.171). The median (range) operative time was 21.5 (4—90) minutes in group A and 13 (5—70) minutes in group B (p < 0.001). Forty seven (94%) stones needed disintegration in group A versus 22 (44%) in group B (p < 0.001).Conclusion
Both techniques have comparable success and complications rates. However, percutaneous cystolithotripsy has a shorter operative time and less need for stone disintegration.