Abstract
Objective
To determine the out come of endoscopic treatment of vesical calculi in children and its
long-term effect on urethra.
Patients and Methods
This quasi-experimental study included five hundred patients seen at Almas Medical
center and City Hospital Larkana from January, 2000 to December, 2009. After necessary
investigations and diagnosis, they were divided into two groups on the basis of having
either small or large size stone in urinary bladder. A pediatric cystoscope of 8Fr size with
angled eyepiece and straight working channel and Swiss lithoclast lithotripter were used
for the procedure.
Results
Out of 500 children, Group 1 comprised of 350 (70%) cases who had radiological
measurement of stone size less than 2.0 cm whereas, Group 2 comprised of 150 (30%)
cases and had stone 2.0 to 3.0 cm in size. The mean age was 4.6 year. Male to female
ratio was 9:1. The stones were disintegrated and removed successfully in all the cases.
Postoperative recovery was uneventful and statistically no significant difference was
found between two groups. The mean operative time was 25 minutes (range 15 to 35
minutes) and 45 minutes (range 30 to 55 minutes) in group 1 and group 2 respectively
and difference was statistically significant (P<0.05). Postoperative Foley’s catheter of 8
or 10 Fr was left only in 175 (35%) cases. Operative complications like urethral and
bladder bleeding, and infection occurred in 37 (7.5%), 30 (6%) and 18 (3.5%) cases
respectively. The mean hospitalization time was 1.2 days (range 1-3 days), and the mean
follow-up was 1.3 months (range 1-6 months). Recurrent vesical calculus and stricture
urethra was observed only in 15 (3%) and two (0.4%) cases respectively.
Conclusion
Cystolithotripsy with Swiss Lithoclast is highly effective, safe and associated with few
short-term and long-term complications. We recommend it as a primary first-line
treatment modality for up to 3.0 cm vesical calculi in children. (Rawal Med J 2010;35:

Key words: Vesical calculi, urethral stricture, cystolithotripsy.