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Paediatric ureteroscopy for ureteric calculi: a 4-year experience
S S al Busaidy1, A R Prem, M Medhat
1Department of Urology, Armed Forces Hospital, Muscat, Sultanate of Oman.
British Journal of Urology
|December 11, 1997
Summary
Ureteroscopy is a safe and effective treatment for pediatric ureteral stones, particularly in the lower and mid ureter. While slightly less effective for upper ureteral calculi, it offers a high stone-free rate with minimal complications.
Area of Science:
- Pediatric Urology
- Endourology
- Nephrolithiasis Management
Background:
- Ureteral calculi in children pose a management challenge.
- Minimally invasive techniques are preferred for pediatric stone removal.
Purpose of the Study:
- To evaluate the efficacy and safety of ureteroscopy for treating pediatric ureteral stones.
- To assess outcomes based on stone location within the ureter.
Main Methods:
- Retrospective analysis of 50 ureteroscopies in 43 children (6 months-12 years).
- Stones located in upper, mid, and lower ureters.
- Electrohydraulic lithotripsy (EHL) used for fragmentation.
- Follow-up included intravenous urograms and micturating cystography (MCUG).
Main Results:
- An overall stone-free rate of 93% was achieved.
- Success rates were 78% (upper), 100% (mid), and 97% (lower ureter).
- Minor complications included two ureteric perforations and transient, clinically insignificant vesico-ureteric reflux.
Conclusions:
- Ureteroscopy is safe and effective for mid and lower ureteral calculi in children.
- Outcomes for upper ureteral calculi were marginally inferior.
- Judicious use of ureteroscopy minimizes ureteric injury and vesico-ureteric reflux.