Management of Lower Urinary Tract Stones in Paediatric Population. A Comparison of Endoscopic versus Open Procedures

Objective: To compare the safety and efficiency of endoscopic treatment methodology vs open surgical procedures in pediatric lower tract stone disease. Method: This study was conducted in Department of Urology, Karachi Medical and Dental College & Abbasi Shaheed Hospital, from July 2010 to December 2012. The characteristics of the patients in the two groups, and the outcomes of the two procedures, the endoscopic treatment (Group A) vs. the open surgery procedure (Group B) for lower urinary tract stone disease, were compared. Results: In both groups, age range was 1 to 16 years with male to female ratio was 2:1 and 1.7:1. In group A and B in that order, size of stone was 0.8 to 1.6cm and 0.7 to 2 cm, average duration of surgery was 39 and 31 minutes. Stone clearance was 98 and 100 percent respectively. Total post operative hospital stay was 18 to 24 hours in group A, and 5 to 10 days in group B patients. The post operative duration of indwelling catheter was 0.8 to 1 day in Group A , and 5 to 15 days in Group B. No drains were placed in group A patients while group B patients had drains for minimum duration of 2 days. Significant wound infection was found in group B patients. Conclusion: Endoscopic management of lower tract stones in paediatric population is the more effective treatment modality with minimum complications, short duration of indwelling urethral catheter and minimum procedure related hospital stay.