Primary versus secondary ureteroscopy for pediatric ureteral stones

Area of Science:

• Pediatric Urology
• Endourology
• Nephrolithiasis Management

Background:

• Pediatric ureteral stones pose a challenge in treatment.
• Ureteroscopy is a common treatment modality.
• The role of pre-stenting in pediatric ureteroscopy requires further evaluation.

Purpose of the Study:

• To compare the outcomes of primary ureteroscopy versus secondary ureteroscopy (with pre-stenting) for treating ureteral stones in children.
• To assess key metrics including stone clearance, need for ureteric dilation, and complications.

Main Methods:

• Retrospective chart review of 66 children under 12 years old with ureteral stones.
• Group A: Primary ureteroscopy without pre-stenting (n=42).
• Group B: Ureteroscopy after ureteric stenting (n=24).
• Postoperative KUB radiographs assessed stone clearance and stent position.

Main Results:

• No significant differences in age, gender, stone location, or size between groups.
• Group A (primary): 73.8% required ureteric dilation, 59.5% achieved complete stone clearance, and 52% needed postoperative stenting.
• Group B (secondary): 95.8% complete stone clearance, no ureteric injury, and 12.5% required postoperative stenting.

Conclusions:

• Secondary ureteroscopy with pre-stenting is superior to primary ureteroscopy in pediatric ureteral stone management.
• Pre-stenting leads to a lower need for ureteric dilation, shorter procedure times, and higher stone clearance rates.
• This approach enhances safety and efficacy in pediatric endourology.