Transurethral Cystolithotripsy vs Percutaneous Cystolithotomy for Bladder Stones in Children: A Systematic Review and Meta-Analysis Comparing Clinical Outcomes and Complications

Background: The minimally invasive treatment of bladder stones (BS) in children has been demonstrated to be safe and effective by both transurethral cystolithotripsy (TUCL) and percutaneous cystolithotomy (PCCL). The surgical outcomes and potential complications associated with these two treatments remain uncertain. We conducted a meta-analysis to compare TUCL and PCCL in pediatric BS with a focus on long-term stone-free rates (SFR), postoperative complications, and cost-effectiveness. Materials and Methods: PubMed, Embase, Cochrane Library, and Web of Science were last searched on September 12, 2023. Included studies should evaluate at least one of the following outcomes: SFR, operation time, hospital stay, and complications. The quality assessment of the studies was performed using the Cochrane tools and Newcastle-Ottawa Scale system. Results: A total of 397 patients from 7 studies met the inclusion criteria, of which 202 patients underwent TUCL and 195 patients underwent PCCL. The results showed that the PCCL group had shorter operative time (p < 0.00001) and longer hospitalization days (p < 0.00001) than the TUCL group, and other perioperative prognostic differences were not statistically significant. Conclusion: TUCL and PCCL are effective and safe for the treatment of BS in children. Multicenter, large-patient series, and prospective studies are needed to determine the critical value of stone size for selecting the surgical approach.