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Management of ureteral stones in pediatric patients
D Delakas1, G Daskalopoulos, M Metaxari
1Department of Urology, University General Hospital of Heraklion, Crete, Greece. delakas@mail.gr
Insights
Shockwave lithotripsy (SWL) is effective for pediatric ureteral stones. Ureteroscopy offers a successful alternative for cases where SWL fails, ensuring high stone clearance rates.
Area of Science:
- Pediatric Urology
- Endourology
- Nephrolithiasis Management
Background:
- Ureteral stones in children present unique management challenges.
- Evaluating treatment modalities for pediatric ureteral calculi is crucial.
Purpose of the Study:
- To assess the 5-year experience with shockwave lithotripsy (SWL) and ureteroscopy for pediatric ureteral stones.
- To determine the efficacy and safety of combined SWL and ureteroscopy in pediatric patients.
Main Methods:
- A cohort of 25 pediatric patients with ureteral stones underwent SWL.
- Patients were stratified by stone location (upper, middle, lower ureter) and size (5-14 mm).
- Ureteroscopy was employed for patients who did not achieve stone clearance with SWL.
Main Results:
- An overall stone clearance rate of 84% was observed at 3 months in the SWL group.
- Four pediatric patients (16%) who failed SWL achieved successful stone removal via ureteroscopy.
- Complications associated with both treatment modalities were infrequent and minor.
Conclusions:
- Shockwave lithotripsy demonstrates safety and efficiency as a primary treatment for pediatric ureteral stones.
- Ureteroscopy serves as a valuable and successful secondary treatment option for SWL failures in pediatric patients.
Purpose:
We report our 5-year experience in the management of ureteral stones in pediatric patients using shockwave lithotripsy (SWL) in combination with ureteroscopy.
Patients And Methods:
A total of 25 children (age range 12 months-14 years; mean 8.7 years) underwent SWL for ureteral lithiasis. Stones were located in the upper ureter in 6 children (24%), the middle ureter in 8 (32%), and the lower ureter in 11 (44%). Their size ranged from 5 to 14 mm (mean 10.9 mm). The children who failed SWL underwent ureteroscopic treatment.
Results:
In the SWL-only group, the overall stone clearance rate at 3 months was 84% (21 of 25 children). Four children (16%) who failed SWL underwent successful ureteroscopic treatment. Complications were infrequent and generally minor in both groups.
Conclusions:
Shockwave lithotripsy is a safe and efficient treatment modality for ureteral stones in pediatric patients. In expert hands, ureteroscopy can be successfully applied in case of SWL failure.