Flexible ureteroscopy for upper ureteral calculi in children
Rajendra B Nerli1, Shivagouda M Patil, Ajay Kumar Guntaka
1Department of Urology, Jawaharial Nehru Medical College, KLE University, Belgaum, India. director@kleskf.org
Insights
Flexible ureteroscopy effectively treats upper ureteral stones in children. High stone-free rates are achievable with this minimally invasive approach, especially for smaller, single stones.
Area of Science:
- Pediatric Urology
- Endourology
- Pediatric Nephrology
Background:
- Ureteroscopy is a key treatment for pediatric urinary stone disease.
- Existing literature often focuses on mid to distal ureteral stones.
- This study investigates flexible ureteroscopy for upper ureteral calculi in children.
Purpose of the Study:
- To evaluate the efficacy of flexible ureteroscopy in managing upper ureteral stones in pediatric patients.
- To assess stone-free rates and complications associated with this procedure.
Main Methods:
- Prospective study including children with upper ureteral stones.
- Evaluation of stone burden, operative access, intraoperative and postoperative complications.
- Assessment of stone-free rates after ureteroscopic procedures.
Main Results:
- 88 ureteroscopic procedures were performed on 80 children.
- 90% of children achieved complete stone clearance in a single session.
- An additional 7.5% achieved clearance after a second session.
Conclusions:
- Flexible ureteroscopy is a viable option for pediatric upper ureteral stones.
- High success rates are possible, particularly for single, small (<10 mm) stones.
- Optimal outcomes are associated with stones located below the pelviureteral junction.
Introduction:
Ureteroscopy is one of the therapeutic options in the management of urinary stone disease in children. Previous literature has described ureteroscopy primarily in mid to distal ureteral calculi. We report our experience with flexible ureteroscopy in the management of upper ureteral calculi.
Patients And Methods:
All children with upper ureteral stones were included prospectively in the study. Stone burden was measured in millimeters. Presentation, operative access, intraoperative complications, stone-free rates, and postoperative complications were evaluated.
Results:
A total of 80 children (69 boys and 11 girls) underwent 88 ureteroscopic procedures. In 72 (90%) children, complete stone clearance was achieved after a single ureteroscopic session. In 6 (7.5%) others, complete stone clearance was achieved after the second ureteroscopic session.
Conclusions:
Complete stone clearance after single ureteroscopy is possible if the calculi are single, small (<10 mm), and below the level of the pelviureteral junction.
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