Micro-ureteroscopy for the treatment of distal ureteral calculi in children
Mehmet Mazhar Utanğaç1, Ahmet Ali Sancaktutar1, Abdulkadir Tepeler2
1Department of Urology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
Insights
Micro-ureteroscopy (micro-URS) effectively treated pediatric distal ureteral stones in 11 children. This safe procedure achieved a 100% stone-free rate with minimal complications, demonstrating its value in pediatric urology.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Endourology
Background:
- Distal ureteral stones pose a challenge in pediatric patients.
- Effective and safe treatment options are crucial for this population.
Purpose of the Study:
- To evaluate the efficacy and safety of micro-ureteroscopy (micro-URS) for treating distal ureteral stones in children.
- To assess perioperative data and outcomes of micro-URS in pediatric patients.
Main Methods:
- Retrospective evaluation of 11 pediatric patients who underwent micro-URS for distal ureteral calculi.
- Procedures performed using a 4.85 Fr micro-ureteroscope under general anesthesia.
- Assessment of demographics, operative time, complications, hospitalization, and stone-free status.
Main Results:
- All 11 pediatric patients achieved stone-free status.
- The median stone size was 10.5mm, and the median operative time was 36.8 minutes.
- Only one case of mild postoperative hematuria (Clavien grade 1) was observed; no intraoperative complications occurred.
Conclusions:
- Micro-ureteroscopy (micro-URS) is a safe and effective treatment for pediatric distal ureteral stones.
- The procedure demonstrated a high success rate and favorable safety profile.
- Further prospective studies comparing different instrument sizes are recommended.
Objective:
The objective of this study was to demonstrate the efficacy and safety of micro-ureteroscopy (micro-URS) in the management of distal ureteral stones in the pediatric population.
Materials And Methods:
A total of 11 children, who had undergone micro-URS between September 2015 and April 2016 with the indication of distal ureteral calculi in two referral centers, were retrospectively evaluated. The procedures were performed with the patient in the lithotomy position under general anesthesia using the standard URS technique with a micro-ureteroscope that has a caliber of 4.85 Fr all along its length. Demographics, perioperative data, and outcomes were assessed.
Results:
Right (n=6) and left (n=8) ureteral stones were detected in the respective number of patients. The mean age of the children was calculated as 55.1months (range, 6-161months). The median stone size was 10.5mm (range, 6-24mm). The median operative time was 36.8min (range, 23-68min). A double 3 stent was implanted in 3 of 11 patients because of severe edema. As a postoperative complication mild hematuria (Clavien grade 1) was observed in one case and resolved spontaneously. Intraoperative minor or major complication did not occur in any of the cases. The mean hospitalization time was determined as 21.4h (range, 10-28h). Stone-free status was accomplished in all patients in the final assessment.
Conclusion:
The outcomes of our series show that micro-URS can be used safely and effectively in the treatment of pediatric distal ureteral stones. Further prospective and comparative studies comparing instruments of different size are warranted.
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