[39] Management of pouch stones in a paediatric cohort: Single-centre experience

Objective: To report our experience with different approaches for management of pouch stones in children with an ileal-based urinary reservoir. Methods: A retrospective review was performed through our electronic database of children who underwent ileal-based urinary reservoirs between 2000 and 2009...

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Autores principales:	Mohamed Ali Mohsen, Hossam Nabeeh, Tamer Helmy, Ashraf Hafez, Mohamed Dawaba
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2018
Materias:	Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/6bea8dc082184443820f1294a3b9969b
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spelling	oai:doaj.org-article:6bea8dc082184443820f1294a3b9969b2021-12-02T10:23:51Z[39] Management of pouch stones in a paediatric cohort: Single-centre experience2090-598X10.1016/j.aju.2018.10.086https://doaj.org/article/6bea8dc082184443820f1294a3b9969b2018-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X18301803https://doaj.org/toc/2090-598XObjective: To report our experience with different approaches for management of pouch stones in children with an ileal-based urinary reservoir. Methods: A retrospective review was performed through our electronic database of children who underwent ileal-based urinary reservoirs between 2000 and 2009. Patients who were diagnosed with reservoir calculi were identified. Perioperative medical records were reviewed for patients’ demographics, diversion details, stone criteria, mode of treatment, complications, and recurrence rate. Results: In all, there were 26 patients with pouch stones [11 boys (42%) and 15 girls (58%)], with a mean (range) age of 11 (4–16) years. The main presentation was incidentally discovered in 10 patients (39%), haematuria in nine (34%), pain in six (23%), and urinary retention in one (4%). In all, 15 cases were post bladder augmentation and 11 post bladder neck closure augmentation ileocystoplasty and continent cutaneous outlet. All cases underwent urinary diversion for non-malignant causes. The mean (range) stone size was 4 (1–10) cm and mean (range) HU was 672 (205–1091). In all, 22 children had positive urine cultures, whilst four were sterile. Nine (35%) children required open poucholithotomy, whilst 17 (65%) were managed endoscopically. A percutaneous approach was used in eight children and urethral access was used in nine. Mechanical extraction was performed in seven children and stone disintegration was required in 10. Pouch injury occurred in two children, which required prolonged catheterisation. Six children developed stone recurrence after 3–12 months, all were after endoscopic disintegration and all required redo endoscopic extraction. Conclusion: Pouch stone is an established long-term complication of urinary diversion. Open and endoscopic approaches are feasible in this cohort, but the recurrence rate is high with the endoscopic approach.Mohamed Ali MohsenHossam NabeehTamer HelmyAshraf HafezMohamed DawabaTaylor & Francis GrouparticleDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 16, Iss , Pp S19- (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Diseases of the genitourinary system. Urology RC870-923 Mohamed Ali Mohsen Hossam Nabeeh Tamer Helmy Ashraf Hafez Mohamed Dawaba [39] Management of pouch stones in a paediatric cohort: Single-centre experience
description	Objective: To report our experience with different approaches for management of pouch stones in children with an ileal-based urinary reservoir. Methods: A retrospective review was performed through our electronic database of children who underwent ileal-based urinary reservoirs between 2000 and 2009. Patients who were diagnosed with reservoir calculi were identified. Perioperative medical records were reviewed for patients’ demographics, diversion details, stone criteria, mode of treatment, complications, and recurrence rate. Results: In all, there were 26 patients with pouch stones [11 boys (42%) and 15 girls (58%)], with a mean (range) age of 11 (4–16) years. The main presentation was incidentally discovered in 10 patients (39%), haematuria in nine (34%), pain in six (23%), and urinary retention in one (4%). In all, 15 cases were post bladder augmentation and 11 post bladder neck closure augmentation ileocystoplasty and continent cutaneous outlet. All cases underwent urinary diversion for non-malignant causes. The mean (range) stone size was 4 (1–10) cm and mean (range) HU was 672 (205–1091). In all, 22 children had positive urine cultures, whilst four were sterile. Nine (35%) children required open poucholithotomy, whilst 17 (65%) were managed endoscopically. A percutaneous approach was used in eight children and urethral access was used in nine. Mechanical extraction was performed in seven children and stone disintegration was required in 10. Pouch injury occurred in two children, which required prolonged catheterisation. Six children developed stone recurrence after 3–12 months, all were after endoscopic disintegration and all required redo endoscopic extraction. Conclusion: Pouch stone is an established long-term complication of urinary diversion. Open and endoscopic approaches are feasible in this cohort, but the recurrence rate is high with the endoscopic approach.
format	article
author	Mohamed Ali Mohsen Hossam Nabeeh Tamer Helmy Ashraf Hafez Mohamed Dawaba
author_facet	Mohamed Ali Mohsen Hossam Nabeeh Tamer Helmy Ashraf Hafez Mohamed Dawaba
author_sort	Mohamed Ali Mohsen
title	[39] Management of pouch stones in a paediatric cohort: Single-centre experience
title_short	[39] Management of pouch stones in a paediatric cohort: Single-centre experience
title_full	[39] Management of pouch stones in a paediatric cohort: Single-centre experience
title_fullStr	[39] Management of pouch stones in a paediatric cohort: Single-centre experience
title_full_unstemmed	[39] Management of pouch stones in a paediatric cohort: Single-centre experience
title_sort	[39] management of pouch stones in a paediatric cohort: single-centre experience
publisher	Taylor & Francis Group
publishDate	2018
url	https://doaj.org/article/6bea8dc082184443820f1294a3b9969b
work_keys_str_mv	AT mohamedalimohsen 39managementofpouchstonesinapaediatriccohortsinglecentreexperience AT hossamnabeeh 39managementofpouchstonesinapaediatriccohortsinglecentreexperience AT tamerhelmy 39managementofpouchstonesinapaediatriccohortsinglecentreexperience AT ashrafhafez 39managementofpouchstonesinapaediatriccohortsinglecentreexperience AT mohameddawaba 39managementofpouchstonesinapaediatriccohortsinglecentreexperience
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[39] Management of pouch stones in a paediatric cohort: Single-centre experience

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