title: Outcomes of Ureteroscopic Management of Pediatric Urolithiasis: A Comparative Analysis of Prepubertal and Adolescent Patients.
abstract: OBJECTIVE
  To compare the outcomes of ureteroscopic intervention in terms of both the stone-free rate and complications in both prepubertal and adolescent patients. Although safety of pediatric ureteroscopic intervention is well established, a comparative outcome of prepubertal and adolescent patients is lacking.
  
  
  METHODS
  Pediatric patients who underwent ureteroscopic treatment of a renal or ureteral stone at our institution from July 2005 to August 2014 were retrospectively identified. Patients were classified by age either as prepubertal (≤11 years) or adolescent (>11 years) for purposes of comparison. Demographic and intraoperative variables as well as 30-day postoperative complication rates were compared between groups. Data were analyzed using χ(2) and Fisher's exact tests as appropriate.
  
  
  RESULTS
  A total of 104 patients were identified, of whom 64 (62%) were prepubertal and 40 (38%) were adolescent. Ureteroscopic failure occurred in a minority of patients (5% vs 4.7%, P > .9). Complication rates including ureteral perforation (0% vs 1.6%, P > .9), postoperative urinary tract infection (2.5% vs 4.7%, P > .9), hematuria with clot passage (0% vs 7.8%, P = .15), and persistent flank pain (15% vs 17%, P = .85) were not significantly different between adolescent and prepubertal patients, respectively.
  
  
  CONCLUSIONS
  In spite of small size and small body habitus, the ureteroscopic management of pediatric urolithiasis can be performed successfully in both the prepubertal and adolescent patients with acceptable and equivalent morbidity as well as successful clearance of stone.
authors.affiliation: Division of Pediatric Urology, Children's Hospital of Pittsburgh, Pittsburgh, PA. Electronic address: pankaj.dangle@chp.edu.
authors.forename: Pankaj P
authors.initials: PP
authors.lastname: Dangle
authors.affiliation: Department of Urology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Jathin
authors.initials: J
authors.lastname: Bandari
authors.affiliation: Department of Urology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Lyon
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Andy
authors.initials: A
authors.lastname: Lee
authors.affiliation: Department of Urology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Omar
authors.initials: O
authors.lastname: Ayyash
authors.affiliation: Division of Pediatric Urology, Children's Hospital of Pittsburgh, Pittsburgh, PA.
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Cannon
authors.affiliation: Division of Pediatric Urology, Children's Hospital of Pittsburgh, Pittsburgh, PA.
authors.forename: Francis X
authors.initials: FX
authors.lastname: Schneck
authors.affiliation: Division of Pediatric Urology, Children's Hospital of Pittsburgh, Pittsburgh, PA.
authors.forename: Heidi A
authors.initials: HA
authors.lastname: Stephany
authors.affiliation: Division of Pediatric Urology, Children's Hospital of Pittsburgh, Pittsburgh, PA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Ost
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery; D018666:Ureteroscopy / Q000009:adverse effects; D052878:Urolithiasis / Q000601:surgery*