Safety and Efficacy of Pediatric Ureteroscopy for Management of Calculous Disease

Thomas, Raju; Ortenberg, Joseph; Lee, Barry R.; Harmon, Edwin

doi:10.1016/s0022-5347(17)36302-4

Cited by 86 publications

(33 citation statements)

References 15 publications

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“…Thomas et al reported a similar incidence of mechanical dilatation in their series of 18 ureteroscopies In two other children the procedure was abandoned in performed in 16 children [8]. Cumulative data from five eÂective means of fragmentation but it remains the most expensive form of intra-ureteric lithotripter to purchase, series comprising 33 children (Table 2) suggests that mechanical dilatation is seldom required [3,4,[9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Paediatric ureteroscopy for ureteric calculi: a 4‐year experience

Busaidy

Prem

Medhat

1997

British Journal of Urology

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Objective To study the eÃcacy and safety of ureterosand 97% of the procedures in the upper, mid and lower ureters, respectively. In three children the procedure copy in the management of paediatric ureteric calculi at various levels. failed and they were salvaged by ureterolithotomy. During the procedures, an upper ureteric Patients and methods The records of 50 ureteroscopic procedures performed on 43 children (age range 6 perforation occurred in one patient and a lower perforation in another. MCUG revealed low grade vesicomonths-12 years) for primary ureteric calculi or ureteric fragments after electrohydraulic shockwave lithotripsy ureteric reflux in 17% of the patients, but close followup showed the reflux to be sterile and clinically (EHWL) were analysed retrospectively. The distribution of the calculi was in nine in the upper upper, seven in insignificant. Conclusion Ureteroscopy was safe and eÂective for the the mid and 30 in the lower ureter, with a mean stone burden of 1.26 cm. Ureteroscopy was performed with management of mid and lower ureteric calculi but the results for upper ureteric calculi were marginally the 8.5/9.5/11.5 F Wolf ureteroscopes, and EHL was used as the primary method of fragmentation.inferior. Ureteroscopy must be performed judiciously to minimize ureteric injury in children. The incidence Intravenous urograms were available in 34 children (79%) and micturating cystography (MCUG) was perof vesico-ureteric reflux after mechanical dilatation of the intramural ureter was infrequent and clinically formed in 23 children (54%) during the follow-up. Results An overall stone-free status was achieved in 40 insignificant. Keywords Electrohydraulic lithotripsy, paediatrics, children (93%) after performing 47 ureteroscopies (94%). Stones were completely cleared in 78%, 100% ureter, ureteric calculi, ureteroscopy in 43 children with ureteric calculi to evaluate the safety

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Section: Discussionmentioning

confidence: 99%

Paediatric ureteroscopy for ureteric calculi: a 4‐year experience

Busaidy

Prem

Medhat

1997

British Journal of Urology

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“…A review of series of pediatric ureteroscopic lithotripsy, reveals a stone free rate of 77-100% after one procedure, comparable with the published stone free rates with SWL. [43,46,[48][49] Stone location was predominantly in the distal ureter, in most of these series. Raza et al reported their experience with ureteroscopy in the treatment of pediatric urinary tract calculi in 35 patients aged 11 months to 15-years (mean 5.9 years).…”

Section: Pediatric Ureteroscopic Lithotripsymentioning

confidence: 77%

“…[39] Voiding cystograms done on pediatric patients after ureteroscopic procedures, have shown the incidence of low grade VUR to be as high as 15%. [41][42][43] Raza et al suggested that dilatation of the vesicoureteral junction is usually not necessary with ureteroscopes <8F. [44] Dilatation allows safer passage of larger ureteroscopes with less potential for ureteral perforation and improved visualization and also allows removal of larger stone fragments.…”

Section: Pediatric Ureteroscopic Lithotripsymentioning

confidence: 99%

Current status of minimally invasive management of pediatric upper urinary tract calculi

Kolla

Wadhwa

Aron

2006

J Indian Assoc Pediatr Surg

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ABSTRACT ABSTRACT ABSTRACTThe surgical management of pediatric upper urinary tract calculi has evolved from open surgery to minimally invasive techniques. With advancement in instrumentation, endourological procedures are being performed more commonly in children. However, the endourological management of renal and ureteral stones in the pediatric population is considered challenging, owing to the smaller size of the urinary tract. Various minimally invasive techniques that are being applied in the management of pediatric urolithiasis, include shock wave lithitripsy (SWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopy and a combination of these procedures. The role of SWL is well established and is considered the first line of treatment in the management of urinary calculi in pediatric patients. Recent reports have confirmed the safety of PCNL and ureteroscopy in children, although they are not as widely practiced in children as in adults. This article reviews literature published till October 2005, pertaining to the minimally invasive management of pediatric upper urinary tract calculi.

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“…Some surgeons actively dilate the ureter before URS in all pediatric patients with ureteral stone [15] , whereas others restrict it to some (30%) [14] or never carry out an active dilatation before URS [16] . Due to possible complications, such as ureteral stricture [14] and/or postoperative vesicoureteral reflux [3,17] , active ureteral dilatation was not performed in all of our patients. Instead, we preferred passive dilatation with preoperative ureteral stent placement for initially inaccessible ureters, in agreement with Hubert and Palmer [18] .…”

Section: Discussionmentioning

confidence: 99%

Ureteroscopic Stone Management in Prepubertal Children

Özkan

Bakan²,

Mil³

et al. 2010

Urol Int

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Introduction: We retrospectively assessed our experience with ureteroscopy (URS) for ureteric calculi in prepubertal children. Patients and Methods: The records of all children who underwent URS at our institution for ureteral calculi between September 2007 and July 2009 were retrospectively reviewed. Patient demographics, stone location and size, pre- and postoperative stenting, intraoperative active dilatation, stone-free rates and complications were noted. Results: A total of 26 patients (20 males and 6 females; mean age 59.9 months) underwent 30 URS procedures with rigid ureteroscopes for 31 ureteral calculi. The mean size of ureteral stones was 8.6 mm. A total of 18 URS procedures were performed without any active ureteral dilatation, and 8 patients underwent 12 passive dilatations of initially inaccessible ureters. Stents remained in place for 2–4 weeks. The stone-free rate was 84.6% for all patients and all procedures. Postoperatively, 12 patients (46%) had stent placement for 2–5 days because of stone burden, edema of the ureteral orifice and hematuria. Conclusions: URS treatment of ureteral stones without active dilatation can be performed safely and effectively in prepubertal children. Passive ureteral dilatation might be necessary in some cases to enable ureteral access.

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Safety and Efficacy of Pediatric Ureteroscopy for Management of Calculous Disease

Cited by 86 publications

References 15 publications

Paediatric ureteroscopy for ureteric calculi: a 4‐year experience

Paediatric ureteroscopy for ureteric calculi: a 4‐year experience

Current status of minimally invasive management of pediatric upper urinary tract calculi

Ureteroscopic Stone Management in Prepubertal Children

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