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Percutaneous cystolithotomy in a patient with a Mitrofanoff urinary diversion

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Ruiz, María Juliana Arcila
Bernal, Andrés Felipe Puentes




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Elsevier Doyma


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Introduction and objectives Bladder stones are the most common calculi of the lower genitourinary tract. The most common predisposing factor is the bladder outlet obstruction. The present case concerns a patient who suffered urethral trauma after a pelvis fracture, requiring a Mitrofanoff urinary diversion, and was diagnosed with multiple cystolithiasis up to 1 cm. The objective of these paper is to show the possibility of performing a percutaneous cystolithotomy in a patient with a complex urinary diversion, being an intervention with low morbidity, and with shorter recovery time and comparable results in terms of stone free percentage rate. Materials y methods The procedure starts with a prior Mitrofanoff catheterisation with a Foley catheter 12. An ultrasound-guided suprapubic left paramedian puncture was performed, followed by Chiba needle hydrophilic guidewire, stiletto, telescoped Alken dilators 9Fr-22Fr, and 28Fr Amplatz sheath. Once the percutaneous tract is established, the nephroscope and foreign body forceps were introduced and complete stone removal was achieved. The procedure ended with the extraction of the Amplatz sheath and occlusion of the wound with gauze dressing, maintaining the bladder diversion with the Foley catheter to a draining collector system. Discharge was given at day 1 post-operative, nad the Foley catheter was removed after 5 days. Results No complications occurred, the operative time was 1 hour, and 1 day of hospital stay. Satisfactory recovery with a successful outcome in terms of complete stone removal in only 1 surgery. Conclusions Percutaneous cystolithotomy is a management option which offers advantages comparable with other techniques. It should not just be considered in patients with urethral restricted access. © 2015 Sociedad Colombiana de Urología
Palabras clave
Article , Bladder obstruction , Bladder stone , Catheterization , Foley balloon catheter , Hospitalization , Human , Lithotomy , Operation duration , Pelvis fracture , Percutaneous cystolithotomy , Treatment outcome , Urinary diversion , Amplatz sheath , Bladder , Bladder stone , Cystolithiasis , Mitrofanoff , Non neurogenic bladder , Percutaneous cystolithotripsy