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Pediatric ureteroscopic stone management.
J Urol. 2005 Sep; 174(3):1072-4.JU

Abstract

PURPOSE

We reviewed our experience of 5 years using ureteroscopy with laser lithotripsy to treat stone disease in prepubertal children.

MATERIALS AND METHODS

A retrospective review was performed of all ureteroscopic procedures performed in prepubertal children.

RESULTS

A total of 33 ureteroscopic procedures were performed in 29 prepubertal children (15 males and 14 females) 5 to 144 months old (mean age 94 months, including 3 patients 24 months or younger). Stones were located in the renal pelvis in 1 case (3%), proximal ureter in 3 (9%), mid ureter in 5 (15%) and distal ureter in 24 (73%). Stone size ranged from 3 to 14 mm (mean 6). Eight patients required balloon dilation of the ureteral orifice. Followup ranged from 1 to 66 months (mean 11). Stone-free rate after initial ureteroscopy and laser lithotripsy was 88%, with all distal and mid ureteral stones (3 to 9 mm, mean 5) successfully treated. Three patients with proximal ureteral stones 7 to 14 mm in diameter (mean 10.3) required a secondary procedure (repeat ureteroscopy in 2 and shock wave lithotripsy in 1) to become stone-free. One patient with cystinuria and a renal pelvic stone measuring 14 mm required shock wave lithotripsy and percutaneous nephrostolithotomy. There were no major complications of ureteroscopy but there was 1 case of extravasation at the ureterovesical junction after balloon dilation that was managed with stent placement.

CONCLUSIONS

Although more patients and longer followup are needed, ureteroscopy with laser lithotripsy is an excellent first line treatment for children with stones in whom conservative therapy fails, especially those with distal and mid ureteral stones. Patients with a stone burden of 10 mm or greater, especially in the proximal ureter, likely will require a secondary procedure to become stone-free.

Authors+Show Affiliations

Division of Pediatric Urology, Vanderbilt Children's Hospital, Nashville, Tennessee 37232-2765, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16094060

Citation

Thomas, John C., et al. "Pediatric Ureteroscopic Stone Management." The Journal of Urology, vol. 174, no. 3, 2005, pp. 1072-4.
Thomas JC, DeMarco RT, Donohoe JM, et al. Pediatric ureteroscopic stone management. J Urol. 2005;174(3):1072-4.
Thomas, J. C., DeMarco, R. T., Donohoe, J. M., Adams, M. C., Brock, J. W., & Pope, J. C. (2005). Pediatric ureteroscopic stone management. The Journal of Urology, 174(3), 1072-4.
Thomas JC, et al. Pediatric Ureteroscopic Stone Management. J Urol. 2005;174(3):1072-4. PubMed PMID: 16094060.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pediatric ureteroscopic stone management. AU - Thomas,John C, AU - DeMarco,Romano T, AU - Donohoe,Jeffrey M, AU - Adams,Mark C, AU - Brock,John W,3rd AU - Pope,John C,4th PY - 2005/8/12/pubmed PY - 2005/9/29/medline PY - 2005/8/12/entrez SP - 1072 EP - 4 JF - The Journal of urology JO - J Urol VL - 174 IS - 3 N2 - PURPOSE: We reviewed our experience of 5 years using ureteroscopy with laser lithotripsy to treat stone disease in prepubertal children. MATERIALS AND METHODS: A retrospective review was performed of all ureteroscopic procedures performed in prepubertal children. RESULTS: A total of 33 ureteroscopic procedures were performed in 29 prepubertal children (15 males and 14 females) 5 to 144 months old (mean age 94 months, including 3 patients 24 months or younger). Stones were located in the renal pelvis in 1 case (3%), proximal ureter in 3 (9%), mid ureter in 5 (15%) and distal ureter in 24 (73%). Stone size ranged from 3 to 14 mm (mean 6). Eight patients required balloon dilation of the ureteral orifice. Followup ranged from 1 to 66 months (mean 11). Stone-free rate after initial ureteroscopy and laser lithotripsy was 88%, with all distal and mid ureteral stones (3 to 9 mm, mean 5) successfully treated. Three patients with proximal ureteral stones 7 to 14 mm in diameter (mean 10.3) required a secondary procedure (repeat ureteroscopy in 2 and shock wave lithotripsy in 1) to become stone-free. One patient with cystinuria and a renal pelvic stone measuring 14 mm required shock wave lithotripsy and percutaneous nephrostolithotomy. There were no major complications of ureteroscopy but there was 1 case of extravasation at the ureterovesical junction after balloon dilation that was managed with stent placement. CONCLUSIONS: Although more patients and longer followup are needed, ureteroscopy with laser lithotripsy is an excellent first line treatment for children with stones in whom conservative therapy fails, especially those with distal and mid ureteral stones. Patients with a stone burden of 10 mm or greater, especially in the proximal ureter, likely will require a secondary procedure to become stone-free. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/16094060/Pediatric_ureteroscopic_stone_management_ L2 - https://www.jurology.com/doi/10.1097/01.ju.0000169159.42821.bc?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -