OUTCOMES OF OPEN VERSUS ENDOSCOPIC PROCEDURES DURING VESICAL CALCULUS MANAGEMENT

OBJECTIVE: To determine the outcomes of open versus endoscopic procedures during vesical calculus management

PATIENTS AND METHODS: The descriptive case series study was conducted in the department of Urology, Liaquate University of Medical and Health Sciences, Jamshoro. One hundred patients having vesical calculus presented to outpatient department who fulfilled inclusion criteria were selected. Informed consent was obtained from their parents/guardians to participate in this study.  Once enrolled, history and physical examination were carried out. Vesical calculus diagnosis was established on X-ray KUB (Kidney, ureter and bladder) and/or ultrasound KUB. The presence of radiopaque shadow and/or movable hypoechoic object(s) with posterior acoustic shadowing were the diagnostic criteria adopted in this study. Simultaneously, size of stone was also noticed. After initial review, full hematology and biochemistry profiles along with urinalysis and urine culture were sent. The patients were admitted then and anesthesia review was obtained.

RESULTS: 100 patients having vesical calculus were were then categorized according to treatment offered i.e. open cystolithotomy versus endoscopic surgery. 1 to 15 years with overall mean±SD age of patients was 6.23±349 years. 94 (94%) were male and 06 (6%) were female. Overall male to female ratio was 15.6:1. Mean (±SD) stone size was 2.57±0.94 mm in open surgery group and 2.68±0.79 mm in endoscopic surgery group. 04 (7%) patients had complications in open surgery group and 02 (4.7%) patients in endoscopic surgery group had complications. Mean (±SD) duration of hospital stay was statistically significant in open surgery group as compared to endoscopic surgery group patients {8.32+1.40 days versus 3.79+1.08 days respectively; p-value=0.001}. .

CONCLUSION: Endoscopic procedures (percutaneous suprapubic cystolitholapaxy and transurethral cystolitholapaxy) are safe and effective in treating pediatric bladder stone disease with minimal operative time, duration of catheterization and length of hospital stay.

KEYWORDS: Vesical calculus, Endoscopic procedures, open procedures.