Percutaneous Lithotripsy of Recurrent Pouch Calculi

Twenty three year old gentleman who is known case of exstrophy with epispadias had undergone cystectomy with catheterisable LeBag ileocolonic pouch construction in 1999. Epispadias repair was performed in 2004. He has had history of recurrent pouch calculi for which he had undergone open pouchotomy and stone removal twice. Examination revealed a battlefield abdomen. His Renal Function Tests were within normal limits. USG and CT revealed a very large capacious pouch with multiple hyperechoic shadows. Both kidneys showed mild PCS dilatation with no hyper echoic shadows. In view of the scarred abdomen we opted for a percutaneous endoscopic preserving the continent mechanisms. We used the PCNL sheath and scope for the same. We report it for the rarity of intervention and difficulties we faced.