This study aimed to compare the safety and efficacy of
laser lithotripsy and pneumatic
lithotripsy, the two most commonly used transurethral
lithotripsy methods for treating
bladder stones in children in Iraq. Between January 2013 and December 2016, 64 children with
bladder stones were included in this prospective randomized study, after ethical committee approval and written consent from the children's parents or caregivers were obtained. Patients were assigned randomly by computer software to two groups treated with either pneumatic cystolithotripsy or
laser lithotripsy. A 9 Fr. semirigid
ureteroscope was used to pass the lithotripter through and fragment the stone. A
catheter of 8-12 Fr. was then introduced and kept in place for 24 h. All children were hospitalized for 24 h, and the
catheter was removed the next morning. Outpatient follow-up was maintained for 6-12 months. In terms of operation outcomes and complications, the
laser lithotripsy group had a significantly longer duration of operation (74.5 ± 26.6 min vs. 51.5 ± 17.2 min, p = 0.001), whereas the number of patients requiring an extended
hospital stay was significantly higher in the pneumatic
lithotripsy group (48.5% vs. 16.1%, p = 0.006). Moreover, pneumatic
lithotripsy was associated with a significantly greater risk of having at least one adverse effect (64% greater than that in the
laser group). Stone clearance rates did not significantly differ between treatment groups. In conclusion, both pneumatic and
laser lithotripters can be used to treat children with
bladder stones with high efficacy and safety.