[Minimally invasive endourological management of urinay tract calculi in children].
BACKGROUND
The urinary tract calculi in children is a very unfrequent problem in the pediatric age group. Endourology plays a major role in pediatric surgery. We reported our experience in endoscopic management of pediatric calculi.


METHODS
Eighteen children (age range: 2 year-19 years) underwent endourology procedures for extraction of urinary tract lithiasis in the period from 1992 until 2006. We reviewed retrospectively the following features: calculi size, location, procedures, surgical complications, recurrent, results and time of follow-up.


RESULTS
Twenty-one endourolgy procedures were performed: nine ureteroscopies (43%), 10 bladder extractions (47.5%) and two percutaneous nephrolithotomies (9.5%). The mean size bladder stone was 2.75 cm. and 6.3 mm. in the ureteral stones. A patient had staghorn calculi. The stone was located in distal ureter in 7 occasions (33.3%), in upper ureter in 2 (9.5%), in kidney in 2 (9.5%), in bladder in 9 (43%) and in urethra in one (4.7%). Ten cases (55.5%) had urology associated anomalies: 6 patients neurogenic bladder, two bladder exstrophy, one ureterocele and one diagnosed of primary megaureter. Four patients (22%) underwent open surgery for the extraction of the lithiasis: a patient with a bladder stone and three cases with ureteral calculi. Three patients (16, 5%) had recurrence of stones and were successfully treated with endoscopy procedure again. By the moment all the patients are stone-free. The time of follow-up has been 2 years and 6 months (range: 1-13 years).


CONCLUSIONS
The endourology is a safe and effective therapeutic option for the management of urinary tract calculi in children. With improvements in instrumentation and technology, it will be possible to expand the patients' selection criterion.
Barbancho
D Cabezalí
DC
Sección de Urología, IServicio de Cirugía Pediátrica, Hospital Universitario 12 de Octubre, Madrid. dcabezali@yahoo.es
Fraile
A Gómez
AG
Sánchez
R Tejedor
RT
Díaz
M López
ML
Otero
J Romero
JR
Vázquez
F López
FL
Bramtot
A Aransay
AA
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018666:Ureteroscopy; D052878:Urolithiasis / Q000628:therapy*