Assessing the Efficacy and Safety of Minimally Invasive Versus Open Bladder Stone Removal in Pediatric Patients

Background: Pediatric bladder stones, although relatively uncommon, pose significant clinical challenges due to their potential to cause urinary obstruction, recurrent urinary tract infections (UTIs), and bladder dysfunction. Effective and minimally invasive treatment options are essential for improving patient outcomes in this population. Objective: To compare percutaneous cystolithotripsy (PCCL) and open vesicolithotomy (OV) in pediatric patients aged 5–15 years, evaluating stone removal efficacy, operative duration, length of hospital stay, and postoperative complication rates. Methodology: This retrospective comparative study was conducted at the Urology Department of Saidu Group of Teaching Hospitals, Swat. A total of 98 pediatric patients (aged 5–15 years) diagnosed with bladder stones were included, with 52 undergoing PCCL and 46 undergoing OV. Data were collected on demographic characteristics, stone size, presenting symptoms, operative time, stone clearance, hospital stay, and complications. Categorical variables were analyzed using the Chi-square test, while continuous variables were assessed with the Student’s t-test. Results: Baseline characteristics, including age (p=0.28), gender (p=0.71), and stone size (p=0.42), were comparable between groups. The mean operative time was significantly lower in the PCCL group (45.6 ± 8.3 minutes) compared to the OV group (72.4 ± 12.7 minutes, p<0.001). Similarly, hospital stay was significantly shorter for PCCL patients (1.9 ± 0.6 days) versus OV patients (3.5 ± 1.2 days, p<0.001). Stone clearance rates were high and similar in both groups, with no statistically significant differences in complication rates such as UTIs, hematuria, or wound infections. Conclusion: PCCL offers a safe and effective alternative to OV in pediatric patients with bladder stones, providing the advantages of shorter operative time and reduced hospital stay without increasing complication risks.