Flexible ureteroscopic lithotripsy for the treatment of upper urinary tract calculi in infants
Jun Li1, Jing Xiao1, Tiandong Han1
1Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Insights
Flexible ureteroscopic lithotripsy is a safe and effective treatment for infant upper urinary tract stones. This minimally invasive procedure offers a high stone-free rate and rapid recovery for pediatric patients.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Nephrolithiasis Treatment
Background:
- Upper urinary tract calculi in infants present unique treatment challenges.
- Flexible ureteroscopic lithotripsy (FURL) is an emerging option for pediatric stone removal.
Purpose of the Study:
- To evaluate the clinical efficacy and safety of FURL for treating upper urinary tract calculi in infants.
- To assess the stone-free rate and complication profile of FURL in this pediatric population.
Main Methods:
- A prospective study included 55 infants with upper urinary tract calculi.
- Flexible ureterorenoscopy with holmium laser lithotripsy was performed.
- Postoperative imaging confirmed stone clearance; complications were monitored.
Main Results:
- A high stone-free rate of 94.6% was achieved after a single FURL session.
- The median operative time was 30 minutes with a median hospitalization of 1-5 days.
- Minor complications occurred in a small percentage of patients, with most recovering without intervention.
Conclusions:
- Flexible ureteroscopic lithotripsy is a safe, highly effective, and minimally invasive treatment for infant upper urinary tract stones.
- This technique facilitates convenient postoperative management and rapid recovery in pediatric patients.
- FURL represents a promising alternative for infants unresponsive to extracorporeal shockwave lithotripsy.
Abstract:
We evaluated the clinical value of flexible ureteroscopic lithotripsy for the treatment of upper urinary tract calculi in infants. Fifty-five infants with upper urinary tract calculi were included in this study: 41 males and 14 females. Retrograde intrarenal surgery was performed by an 8 Fr/30 cm flexible ureterorenoscope (POLY®) combined with a holmium laser. CT scanning or radiography of the kidneys, ureters, and bladder region was performed one month after the operation to confirm the clearance of calculi. All the 55 infants with calculi in 74 sides underwent 66 flexible ureteroscopic lithotripsy procedures. The median operation time was 30 min. The median amount of flushing fluid was 500 mL. The stone-free rate after a single session treatment was 94.6%, within which 10 infants underwent simultaneous bilateral flexible ureteroscopy lithotripsy. Catheters were retained in 45 infants for 24-48 h after the operation. Continuous high fever due to reflux was present in two cases. Flushing fluid extravasation was found in one infant. Some patients with minor complications, such as mild hematuria, irritation symptoms, and low fever, recovered without treatment. The duration of hospitalization time after the operation was approximately 1-5 days. Flexible ureteroscopic lithotripsy is a safe, highly efficient, minimally invasive, and reproducible operation for removal of upper urinary tract calculi in infants. This technique is a convenient method for postoperative management of patients that enhances their rapid recovery. It is a promising option for therapy of infants ineffectively treated by extracorporeal shockwave lithotripsy.
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