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Retrograde ureteroscopy for distal ureteric stone removal in children.
BJU Int. 2005 May; 95(7):1049-52.BI

Abstract

OBJECTIVE

To compare the efficacy and safety of ureteroscopy plus intracorporeal lithotripsy (ULT) with extracorporeal shock wave lithotripsy (ESWL) for treating distal ureteric calculi in childhood, as such stones are commonly treated by ESWL as the first option in adults but there is no agreement on the method of treating them in children.

PATIENTS AND METHODS

From July 2002 to July 2003, children presenting with ureteric stones were consecutively randomized for treatment using ULT or ESWL. The two groups were matched for age, sex and stone position in the distal ureter. A 7.5 F ureteroscope combined with a ballistic lithotripter or holmium-YAG laser was used for ULT. ESWL was administered using a second-generation lithotripter. The success rate, effectiveness quotient, complication rate and hospitalization were evaluated and compared using Student's t-test (chi-square) and Fisher's exact test as appropriate. In all, 31 patients (21 girls and 10 boys, mean age 7.2 years, range 2-17) were treated, by ULT in 17 (12 girls and five boys) and ESWL as a primary procedure in 14 (five boys and nine girls).

RESULTS

After one ULT, all the girls and four boys, and after ESWL, four girls and two boys, were rendered stone-free at the first treatment. The total stone-free rate was 16 of 17 for ULT and six of 14 for ESWL (P = 0.004). Eight patients had a second ESWL and three then became stone-free. The five patients in whom both ESWL treatments failed had a successful ULT. There was no significant difference between the groups in complication rate and hospitalization. General anaesthesia was required in all patients <12 years old treated by ULT or ESWL. The calculated efficiency quotient for treating distal ureteric calculi was significantly lower for ESWL than ULT (P < 0.05).

CONCLUSIONS

ULT should be recommended as the treatment of choice for distal ureteric calculi in children; using small ureteroscopes the target stone was treated safely and effectively.

Authors+Show Affiliations

Division of Paediatric Urology, Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Research Institute, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15839930

Citation

De Dominicis, Mauro, et al. "Retrograde Ureteroscopy for Distal Ureteric Stone Removal in Children." BJU International, vol. 95, no. 7, 2005, pp. 1049-52.
De Dominicis M, Matarazzo E, Capozza N, et al. Retrograde ureteroscopy for distal ureteric stone removal in children. BJU Int. 2005;95(7):1049-52.
De Dominicis, M., Matarazzo, E., Capozza, N., Collura, G., & Caione, P. (2005). Retrograde ureteroscopy for distal ureteric stone removal in children. BJU International, 95(7), 1049-52.
De Dominicis M, et al. Retrograde Ureteroscopy for Distal Ureteric Stone Removal in Children. BJU Int. 2005;95(7):1049-52. PubMed PMID: 15839930.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrograde ureteroscopy for distal ureteric stone removal in children. AU - De Dominicis,Mauro, AU - Matarazzo,Ennio, AU - Capozza,Nicola, AU - Collura,Giuseppe, AU - Caione,Paolo, PY - 2005/4/21/pubmed PY - 2005/5/27/medline PY - 2005/4/21/entrez SP - 1049 EP - 52 JF - BJU international JO - BJU Int VL - 95 IS - 7 N2 - OBJECTIVE: To compare the efficacy and safety of ureteroscopy plus intracorporeal lithotripsy (ULT) with extracorporeal shock wave lithotripsy (ESWL) for treating distal ureteric calculi in childhood, as such stones are commonly treated by ESWL as the first option in adults but there is no agreement on the method of treating them in children. PATIENTS AND METHODS: From July 2002 to July 2003, children presenting with ureteric stones were consecutively randomized for treatment using ULT or ESWL. The two groups were matched for age, sex and stone position in the distal ureter. A 7.5 F ureteroscope combined with a ballistic lithotripter or holmium-YAG laser was used for ULT. ESWL was administered using a second-generation lithotripter. The success rate, effectiveness quotient, complication rate and hospitalization were evaluated and compared using Student's t-test (chi-square) and Fisher's exact test as appropriate. In all, 31 patients (21 girls and 10 boys, mean age 7.2 years, range 2-17) were treated, by ULT in 17 (12 girls and five boys) and ESWL as a primary procedure in 14 (five boys and nine girls). RESULTS: After one ULT, all the girls and four boys, and after ESWL, four girls and two boys, were rendered stone-free at the first treatment. The total stone-free rate was 16 of 17 for ULT and six of 14 for ESWL (P = 0.004). Eight patients had a second ESWL and three then became stone-free. The five patients in whom both ESWL treatments failed had a successful ULT. There was no significant difference between the groups in complication rate and hospitalization. General anaesthesia was required in all patients <12 years old treated by ULT or ESWL. The calculated efficiency quotient for treating distal ureteric calculi was significantly lower for ESWL than ULT (P < 0.05). CONCLUSIONS: ULT should be recommended as the treatment of choice for distal ureteric calculi in children; using small ureteroscopes the target stone was treated safely and effectively. SN - 1464-4096 UR - https://www.unboundmedicine.com/medline/citation/15839930/Retrograde_ureteroscopy_for_distal_ureteric_stone_removal_in_children_ L2 - https://doi.org/10.1111/j.1464-410X.2005.05464.x DB - PRIME DP - Unbound Medicine ER -