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Passive dilation by ureteral stenting before ureteroscopy: eliminating the need for active dilation
Katherine C Hubert1, Jeffrey S Palmer
1Division of Pediatric Urology, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
The Journal of Urology
|August 12, 2005
Summary
Passive dilation using ureteral stents is a safe and effective method for accessing difficult ureteral orifices in children before ureteroscopy. This technique simplifies the procedure and avoids complications, improving outcomes for pediatric patients.
Area of Science:
- Pediatric Urology
- Endourology
- Minimally Invasive Surgery
Background:
- Ureteral orifice access can be challenging during cystoscopy in pediatric patients.
- Difficult access may necessitate alternative dilation techniques prior to ureteroscopy.
Purpose of the Study:
- To evaluate the efficacy and safety of passive dilation via ureteral stenting for inaccessible ureteral orifices in children.
- To assess the role of preoperative stenting in facilitating subsequent ureteroscopic procedures.
Main Methods:
- Retrospective evaluation of pediatric patients (<18 years) with inaccessible ureteral orifices.
- Preoperative placement of ureteral stents for passive dilation.
- Subsequent ureteroscopic procedures using semirigid and/or flexible ureteroscopes.
Main Results:
- 28 passive dilations were performed in 26 children (median age 10.3 years).
- Stent indwelling time ranged from 2 to 8 weeks (median 3 weeks).
- All patients successfully underwent ureteroscopy without requiring active orifice dilation; no complications were reported.
Conclusions:
- Passive dilation with ureteral stents is a simple, successful, and beneficial technique for pediatric ureteral access.
- This method is well-tolerated by children, with no associated complications or adverse events.