title: Primary versus secondary ureteroscopy for pediatric ureteral stones.
abstract: OBJECTIVE
  To evaluate the outcome of primary versus secondary ureteroscopy for pediatric ureteral stones.
  
  
  METHODS
  A retrospective chart review study that included 66 children aged less than 12 years, who were subdivided into two groups: Group A, which included 42 children who had undergone primary ureteroscopy without pre-stenting; and Group B, which included 24 children who had undergone ureteroscopy after ureteric stenting. Kidneys, ureters and bladder radiographs were done on the first postoperative day to assess the degree of stone clearance and stent position.
  
  
  RESULTS
  Age, gender, stone location and stone size were not significantly different between both groups. In Group A, 31 (73.8%) children required ureteric dilation, 13 (31%) had a tight ureter that failed to respond to dilation, 25 (59.5%) displayed complete stone clearance, and of these, 13 (52%) needed postoperative stenting. One child experienced ureteric injury during stone disintegration and was stented for two weeks. Children in Group B experienced a 95.8% complete stone clearance rate, with no ureteric injury reported; postoperative stenting was performed in three (12.5%) children..
  
  
  CONCLUSIONS
  Secondary ureteroscopy is preferable over primary ureteroscopy in pediatric populations because of a significantly lower need for ureteric dilation, shorter procedure time and better stone clearance rate..
authors.affiliation: Department of Urology, Assiut University, Egypt.
authors.forename: M A
authors.initials: MA
authors.lastname: Elgammal
authors.affiliation: Department of Urology, Assiut University, Egypt. Electronic address: assafwat@gmail.com.
authors.forename: A S
authors.initials: AS
authors.lastname: Safwat
authors.affiliation: Department of Urology, Assiut University, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Elderwy
authors.affiliation: Department of Urology, Assiut University, Egypt.
authors.forename: A S
authors.initials: AS
authors.lastname: El-Azab
authors.affiliation: Department of Urology, Qena University, Egypt.
authors.forename: M S
authors.initials: MS
authors.lastname: Abdelkader
authors.affiliation: Department of Urology, Assiut University, Egypt.
authors.forename: H M
authors.initials: HM
authors.lastname: Hammouda
mesh_terms: D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D004106:Dilatation; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi; D018666:Ureteroscopy
keywords: Calculi; Pediatric; Ureteroscopy