Ureteroscopic management of lower-pole stones in a pediatric population.
OBJECTIVE
We report our experience with ureteroscopy to treat lower-pole calculi in children.


METHODS
A retrospective review was conducted of all ureteroscopic procedures for lower-pole stone disease at a pediatric institution from 2000 through 2005. A total of 13 girls and 8 boys with a mean age of 15 years (range 1-20 years) underwent flexible ureteroscopy for lower-pole calculi. The mean stone burden was 12 mm. Stone-free status was defined by postoperative abdominal radiography, CT, or ultrasonography.


RESULTS
Ureteral stenting was performed preoperatively in 38% and postoperatively in 71% of the patients. Ureteral-access sheaths were placed in 43%. There were no intraoperative or postoperative complications. With a mean follow-up of 11 months, 76% of the children were stone-free. The success rate for stones <15 mm was 93% v 33% for stones > or =15 mm (P = 0.01).


CONCLUSIONS
Ureteroscopy and laser lithotripsy are safe and effective in children with lower-pole calculi. Ureteroscopy can be considered a primary treatment option for children with lower-pole calculi <15 mm.
Cannon
Glenn M
GM
Department of Urology, Children's Hospital, Boston, Boston, Massachusetts 02115, USA. glenn.cannon@childrens.harvard.edu
Smaldone
Marc C
MC
Wu
Hsi-Yang
HY
Bassett
Jeffrey C
JC
Bellinger
Mark F
MF
Docimo
Steven G
SG
Schneck
Francis X
FX
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D018666:Ureteroscopy / Q000009:adverse effects / Q000379:methods*