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. 2021 Jul-Aug;26(4):250-252.
doi: 10.4103/jiaps.JIAPS_128_20. Epub 2021 Jul 12.

Percutaneous Cystolithotomy in Augmented Bladders

Uday Sankar Chatterjee  1 , Indranil Chatterjee  2
Affiliations

Percutaneous Cystolithotomy in Augmented Bladders

Uday Sankar Chatterjee et al. J Indian Assoc Pediatr Surg. 2021 Jul-Aug.

Abstract

Aims: Incidence and recurrence of bladder stone in augmented exstrophy bladder rate is high. So, recurrent open cystolithotomy is not a preferred procedure; particularly through scarred tissues, consequence of previous surgeries. Percutaneous cystolithotomy (PCCL) is an old but standard procedure for retrieval of bladder stones in adults. We extrapolated PCCL for bladder stone in augmented bladders in children.

Patients and methods: In three patients, we made suprapubic (SP) needle track with initial puncture (IP) needle under cystoscopic guidance. Following that laparoscopic cannula was placed through dilated SP track that was crafted with Alken's dilators and bladder stones were removed with grasper.

Results: On cystoscopy, we also observed the patches of skin tissues in native bladders. Continence and bladder capacity were not affected following PCCL.

Conclusion: PCCL in augmented bladder showed good outcome. High recurrence of bladder stone is possibly due to presence of keratin in dermal tissue; invaded mucosa in open bladder plate. It seems shaving or fulguration of those dermal elements during bladder reconstruction might decrease incidence of stone formation. However, we haven't attempted fulguration during PCCL.

Keywords: Augmentation; bladder stone; cystoscope; dermal tissue; exstrophy bladder; laparoscopic cannula.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Stone in augmented bladder
Figure 2
Figure 2
Puncture with needle and guide wire is threaded (a). Guide rod is threaded over guide wire (b). Alken's telescopic dilators are threaded over guide rod (c)
Figure 3
Figure 3
Alken's telescopic dilators are threaded over guide rod (a). Laparoscopic cannula is threaded over Alken's dilators (b). Stone retrieved with grasper (c)
Figure 4
Figure 4
Direct puncture with laparoscopic trocar–cannula (a). Tip of trocar visible through mucosa (b)
See this image and copyright information in PMC

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