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[Transurethral ureteropyeloscopy with lithotripsy and lithoextraction in children]

A G Martov, A A Lisenok, A Iu Pavlov

    Urologiia (Moscow, Russia : 1999)
    |August 29, 2007
    PubMed

    Insights

    Transurethral ureteropyeloscopy with lithotripsy and lithoextraction effectively treats pediatric urolithiasis, especially after failed extracorporeal lithotripsy (ELT). This minimally invasive approach offers a safe and successful alternative for stone removal in children.

    Area of Science:

    • Pediatric Urology
    • Endourology
    • Nephrology

    Background:

    • Endoscopic treatment for urolithiasis in adults has shown high efficacy.
    • This success has led to its adoption in pediatric urolithiasis management strategies.

    Observation:

    • 133 ureteropyeloscopies with lithotripsy and lithoextraction were performed on 121 children (aged 11 months to 16 years).
    • Concrements ranged from 0.5-2.0 cm and larger, located in the caliceal-pelvic segment or ureter.
    • 86% of cases involved ureteropyeloscopy following ineffective extracorporeal lithotripsy (ELT).

    Findings:

    • Complete stone removal was achieved in 98 (80.9%) patients.
    • This included cases with ligature stones and ureteral strictures requiring additional procedures.
    • In 23% of cases, drainage with catheters or stents was necessary due to fragment migration, followed by further ELT.
    • Postoperative pyelonephritis occurred in 16.5% of children, managed conservatively.
    • No long-term complications were observed.

    Implications:

    • Transurethral ureteropyeloscopy is a highly effective, minimally invasive, and safe treatment for pediatric urolithiasis.
    • It is particularly valuable when extracorporeal lithotripsy (ELT) fails.
    • This endoscopic technique offers a viable alternative for managing complex pediatric kidney stones.

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