Outcome of ureteroscopy for treatment of pediatric ureteral stones
Ehab Mohamad Galal1, Tarek Khalaf Fath El-Bab, Amr Mohamad Abdelhamid
1Department of Urology, Minia University Hospital, P.O. 61111, Minia, Egypt. galaluro71@yahoo.com
Insights
Semirigid ureteroscopy effectively treats pediatric ureteral stones, achieving an 89% success rate with minimal complications. This minimally invasive procedure offers a safe and feasible option for children requiring stone removal.
Area of Science:
- Pediatric Urology
- Endourology
- Minimally Invasive Surgery
Background:
- Ureteral stones in children present unique diagnostic and management challenges.
- Traditional treatment options may involve higher risks or lower efficacy in pediatric populations.
Purpose of the Study:
- To evaluate the safety and effectiveness of semirigid ureteroscopy for treating ureteral stones in pediatric patients.
- To determine the success rates and complication profiles associated with this minimally invasive approach.
Main Methods:
- Retrospective review of 18 children (mean age 7.6 years) treated with semirigid ureteroscopy (8F) for symptomatic ureteral stones.
- Procedures involved guidewire passage, optional ureteral orifice dilation, and stone management via extraction or pneumatic lithotripsy.
- Follow-up was conducted for 6 months post-procedure.
Main Results:
- Successful ureteroscopic completion in 16 out of 18 children (89% success rate).
- Stones were primarily located in the lower third of the ureter (81%), with a mean size of 7 mm.
- Postoperative complications were minor, including transient hematuria, renal colic, and fever; no long-term complications were observed.
Conclusions:
- Semirigid ureteroscopy is a feasible and safe treatment for pediatric ureteral stones.
- The procedure's success is enhanced by surgeon expertise and leveraging experience from adult treatments.
Purpose:
We assess the efficacy and safety of semirigid ureteroscopy for treatment of ureteral stones in children.
Materials And Methods:
The records of 18 non-consecutive children with symptomatic ureteral stones treated with ureteroscopy in 2008-2010 were reviewed. Mean age was 7.6 years (range 15 months-14 years). A semirigid (8F) ureteroscope was used in all cases. A 0.038-inch floppy-tipped guidewire was passed through the selected ureteric orifice, advanced under direct vision, and monitored fluoroscopically. Dilatation of the ureteral orifice was necessary in 7 cases. Either direct extraction or disintegration using a pneumatic lithotripter was performed. The follow-up period was 6 months.
Results:
Ureteroscopic procedures were successfully completed in 16 children (89%). Stones were located at the middle ureter in 3 (19%) cases and various levels of the lower third ureter in 13 (81%) cases. Stone size was 4-10 mm (mean 7 mm). Stones were fragmented with pneumatic lithotripsy in 9 (56%) cases and removed by forceps without fragmentation in 7 (44%). Stent was left in place for 3 days to 3 weeks in 12 (75%) cases. Early postoperative complications were insignificant hematuria in 2 patients and renal colic and fever in 3 patients. No complications were observed during the period of follow up.
Conclusion:
Ureteroscopy is a feasible treatment option for ureteral stones in children, when in skilled hands and with the aid of experience gained in the adult population.
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