The role of ureteroscopy in pediatric urology.
OBJECTIVE
Endoscopic evaluation and management of the diverse conditions involving the upper urinary tract using rigid or flexible endoscopes is now readily feasible and has been shown to be safe and efficacious even in the smallest children.


RESULTS
Reduction in the size of the endoscopes, improvements in electronic imaging systems, proliferation of ancillary equipment, and improvement in endourologic skills among pediatric urologists make endoscopic treatment of pediatric urolithiasis the treatment of choice. The safety and efficacy of holmium:YAG laser lithotripsy make it the intracorporeal lithotriptor of choice. Successful outcomes can be obtained for ureteral and renal calculi that are similar to the adult population. Endoscopic treatment can be effective in highly selected children with intraluminal ureteral obstruction in the hands of a very experienced endoscopic pediatric urologist. These conditions include renal hemangiomas or arteriovenous malformations, ureteropelvic junction obstruction, ureteral strictures, or ureteral polyps.


CONCLUSIONS
Pediatric ureteroscopic procedures are similar to their adult counterparts, in that basic endoscopic principles should be observed. Nevertheless, children pose specific technical challenges that require planning before endoscopy and that affect the risks and outcomes of these procedures. Future improvements in ureteroscopy will rely on the continued application of the new technology.
Minevich
Eugene
E
Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. Eugene.Minevich@cchmc.org
Sheldon
Curtis A
CA
D002648:Child; D006801:Humans; D010372:Pediatrics / Q000379:methods* / Q000639:trends; D018666:Ureteroscopy / Q000379:methods* / Q000639:trends; D052878:Urolithiasis / Q000601:surgery; D014572:Urology / Q000379:methods* / Q000639:trends