Transureteral lithotripsy in pediatric practice.

Area of Science:

• Pediatric Urology
• Endourology

Background:

• Ureteral stones in children present unique management challenges.
• Minimally invasive surgical options are increasingly preferred for pediatric urolithiasis.

Purpose of the Study:

• To review the efficacy and outcomes of ureteroscopy for treating ureteral stones in pediatric patients.
• To evaluate the success rate and complications associated with ureteroscopic intervention in children.

Main Methods:

• A retrospective review of 66 ureteroscopies performed on pediatric patients (mean age 9 years) over six years.
• Procedures utilized semirigid ureteroscopes (8F-11.5F) under general anesthesia, with stone management including basketing and various lithotripsy methods.
• Pre-procedure imaging included ultrasonography, plain film, or intravenous urography; ureteral dilatation was employed as needed.

Main Results:

• An overall stone-free rate of 88% was achieved within 48 hours post-procedure.
• The complication rate was 23%, primarily consisting of gross hematuria and pyelonephritis; no ureteral perforations or strictures were noted at 3-month follow-up.
• Successful ureteroscope insertion was achieved in most cases, with stone management varying based on size and location, utilizing basketing or lithotripsy.

Conclusions:

• Ureteroscopy demonstrates a high success rate for treating ureteral calculi in pediatric patients.
• Small-caliber ureteroscopy is a highly effective and recommended first-line treatment for distal ureteral stones in children.
• The procedure offers a favorable safety profile with minimal long-term complications.