Safety and outcome of rigid ureteroscopy for management of ureteral calculi in children.
OBJECTIVE
To present our experience with ureteroscopy for the treatment of pediatric ureteral calculi.


METHODS
The records of 32 children with an average age of 8.7 years (range 2-15 years) treated with rigid ureteroscopy between June 1994 and July 2003 were reviewed. In 33 ureteral units, 8F rigid ureteroscopy was carried out 35 times to treat stone disease. Stones were located in the upper ureter in 2 cases, the middle ureter in 2 cases, and the lower ureter in 29 cases. Stone size ranged from 4 to 15 mm (mean 7 mm). Dilatation of the ureteral orifice was necessary in 10 procedures.


RESULTS
The management of stone in 29 children (90.7%) was straightforward, and a single procedure was sufficient to clear the ureters. In 2 children (6.2%), repeat ureteroscopy was undertaken to render the ureters stone free, and in 1 child (3.1%), it was not possible to remove the stone. Stones were fragmented with pneumatic lithotripsy in 2 cases and with the holmium laser in 9; in the remaining 22 cases, the stones were removed without fragmentation. Intraoperative complications occurred in 3 children (9.3%) and consisted of extravasation (1 patient) and stone migration (2 patients). The early postoperative complications were hematuria in one patient and renal colic in another. Of the patients, 28 were followed 3 to 48 months. No stricture was detected at the site of stone impaction in any patient.


CONCLUSIONS
In the hands of an experienced surgeon, ureteroscopy can be a safe and efficient treatment for ureteral stones in children.
El-Assmy
Ahmed
A
Urology & Nephrology Center, Mansoura University, Mansoura, Egypt. a_assmy@yahoo.com
Hafez
Ashraf T
AT
Eraky
Ibrahim
I
El-Nahas
Ahmed R
AR
El-Kappany
Hamdy A
HA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006695:Holmium; D006801:Humans; D017602:Lithotripsy, Laser; D008297:Male; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014514:Ureteral Calculi / Q000601:surgery* / Q000628:therapy; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000009:adverse effects / Q000379:methods*
D006695:Holmium