A randomized trial comparing outcomes of mini-percutaneous cystolithotripsy and transurethral cystolithotripsy in infants less than one year old
Tariq Ahmad, FCPS Urology, FEAPU1, Nasrum Minallah, FCPS Urology2.
1Khyber Teaching Hospital, Peshawar, Pakistan, 2Pakistan Kidney and Liver Institute & Research Centre, Lahore, Pakistan. A randomized trial comparing outcomes of mini-percutaneous cystolithotripsy and transurethral cystolithotripsy in infants less than one yearBackground: The management of urinary bladder stones in infants is very challenging, owing to small sized patients with narrow calibre urethra which needs miniaturized instruments. This study compares the outcomes of mini-percutaneous cystolithotripsy and transurethral cystolithotripsy in infants less than one year.Material and Methods: A total of 52 infants, aged < 1 year, with urinary bladder stones were enrolled in the study. After informed written consent from the parents, the patients were randomized into two equal groups. Group A underwent transurethral cystolithotripsy (TUCL) and Group B underwent mini-percutaneous cystolithotripsy (mPCCL). Diagnostic cystourethroscopy (CU) was performed in all patients before undergoing the procedure. The two groups were compared in terms of stone free rate (SFR) and complication rate.Results: The mean age of infants in group A and group B were 7.2 +/- 3.0 months and 7.3 +/- 2.9 months respectively (p-value > 0.05). The mean stone size in group A and group B were 11.33 +/- 3.8 mm and 11.0 +/- 3.6 mm respectively (p-value > 0.05). The mean operative time was significantly less in mPCCL group than in TUCL group (25.7 +/- 4.1 vs 30.4 +/- 6.3 min,
p-value < 0.05). SFR was 100% in mPCCL group and 96.2% in TUCL groups (p-value > 0.05). The complication rate was significantly less in mPCCL group than in TUCL group (3.8 vs 23.1%, p-value < 0.05).Conclusion: Our study concluded that although, there is no difference in SFR of mPCCL and TUCL for urinary bladder stone in infants, mPCCL is associated with a shorter mean operative time and lower complication rate.Keywords: Bladder Stone, Transurethral cystolithotripsy, Percutaneous cystolithotripsy, Infants
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