Semi-closed-circuit vacuum-assisted mini percutaneous cystolithotomy (VAMPCL) in native and augmented bladders

Abstract

Bladder stones in children are rare, 1-5 % of all urinary tract stones. Historically, open cystolithotomy (OCL) was the standard treatment. New methods such as extracorporeal shock wave cystolithotripsy (ESWCL), percutaneous cystolithotomy (PCL), and transurethral cystolithotripsy (TCL) have been introduced to reduce complications and shorten hospital stays. Advances in miniaturized endoscopes and lithotripters have made PCL a safe and effective alternative. The semi-closed-circuit vacuum-assisted ClearPetra® system is being evaluated for its safety and efficacy in pediatric percutaneous cystolithotomy (vamPCL). This study presents preliminary results from using the vamPCL system on pediatric patients, including those with augmented enterocystoplasty. Six patients aged 55-212 months (median 139 months) underwent vamPCL. All had a Mitrofanoff conduit, and four had augmented bladders. The average stone size was 24 ± 14.2 mm, with a mean operating time of 78.3 ± 14.7 min. No intraoperative complications occurred, though a 24-h fever was noted in one patient post-operatively. Postoperative hospital stay was typically 2 days. Follow-up ultrasounds after 2 months confirmed all patients were stone-free, except one who experienced recurrence after 8 months. The vamPCL procedure appears to be a sustainable, safe, and feasible option for treating bladder stones in selected pediatric patients.

Keywords: Augmented bladder; Bladder calculi; Child; Lithotripsy; Percutaneous cystolithotomy; Urolithiasis.