Ureteroscopy in Pediatric Patients with Spinal Abnormalities

Colangelo, Caroline; Kaplan, George W.; Palazzi, Kerrin; Holmes, Nicholas M.; Chiang, George

doi:10.1089/end.2012.0306

Cited by 13 publications

(7 citation statements)

References 12 publications

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“…Ureteroscopy (URS) has difficult restrictions due to anatomic variations and the high stone burden typical of these patients might require multiple procedures [ 58 ]. SFRs of 35.7–75% and a 40% complication rate were described in several publications [ 59 , 60 ].…”

Section: Resultsmentioning

confidence: 99%

Is There Still a Place for Percutaneous Nephrolithotomy in Current Times?

Lorenzis

Zanetti

Boeri

et al. 2022

JCM

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Background: Percutaneous nephrolithotomy (PCNL) and its miniaturized modifications are usually considered the standard surgical options for large (>20 mm) staghorn and infected stones. Moreover, PCNL is a viable alternative to retrograde intrarenal surgery (RIRS) for smaller stones (<20 mm) in the presence of anatomical malformations or inaccessible lower pole stones. However, due to the advancements in laser and scope technology, RIRS is expanding its indications with the potential benefits of lower complications and a shorter hospital stay. Methods: A literature search using the PUBMED database from inception to June 2022 was performed to explore the current role of PCNL in endourology. The analysis involved a narrative synthesis. Results: PCNL confirmed its role in the treatment of large and complex stones; moreover, miniaturized PCNL has become more competitive, gaining space among classic indications of flexible ureteroscopy. Conclusions: considering all the evaluated subgroups, we can conclude that PCNL is an old fascinating procedure and is here to stay.

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Section: Resultsmentioning

confidence: 99%

Is There Still a Place for Percutaneous Nephrolithotomy in Current Times?

Lorenzis

Zanetti

Boeri

et al. 2022

JCM

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“…In a study of pediatric ureter stone patients with and without spinal deformity, Colangelo et al. [ 13 ] identified serious differences in stone-free rate (SFR) and complication rates for patients with spinal deformity in favor of patients without spinal deformity (success and complications, 61% versus 35.7% and 6.1% versus 40%, respectively). In our case, we did not encounter any complications.…”

Section: Discussionmentioning

confidence: 99%

Retrograde intrarenal surgery for impacted upper ureteral stone in a patient with advanced lumbar scoliosis and lower-extremity development defect: a case report

Güler

2022

J Med Case Reports

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Background Today, retrograde intrarenal surgery is the most preferred and very successful treatment method for upper ureteral stones that do not spontaneously pass and/or do not benefit from extracorporeal wave lithotripsy. However, perioperative complications are more common in retrograde intrarenal surgery if the stone in the ureter is impacted. Moreover, urosepsis and renal dysfunction are detected more frequently in patients with impacted stones. Impacted stones, which are a risky stone group even in patients with normal vertebral anatomy, are a more challenging situation in patients with advanced vertebral scoliosis. It is difficult to achieve an operating position in these patients. In addition, the ureteral tracing is altered, curved, and tortuous, making it more difficult for the endoscope to advance through the ureter. Case presentation In this case report, we present a 23-year-old Caucasian male patient with right concavity and severe scoliosis, lower-extremity developmental disorder, and urosepsis. To treat the urosepsis picture, first percutaneous nephrostomy drainage was provided and the urine was sterilized with appropriate antibiotics according to the culture/antibiogram. Then, we performed ureterolithotripsy with a flexureterorenoscope. Finally, we see that flexible ureterorenoscopic lithotripsy to the upper ureteral stone with impacted stones, which is a very challenging operation even in patients with normal vertebrae, could be successfully performed in our patient with advanced scoliosis deformity. Conclusion High stone-free and low complication rates can be obtained with flexible ureterorenoscopic retrograde intrarenal surgery in medium-sized impacted upper ureteral stones in patients with advanced scoliosis.

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“…In the setting of patients with spinal abnormalities and hardware, ureteral deviation and tortuosity can make URS technically difficult and, in some cases, impossible. In a study of 102 patients undergoing URS, there was a 6 % intraoperative complication rate in patients with normal anatomy versus a 40 % (six patients) intraoperative complication rate in patients with spinal abnormalities; 33 % of patients with spinal abnormalities (five patients) had complications related to an inability to access the ureter/stone in comparison to 4.3 % in those with normal anatomy [34].…”

Section: Surgical Therapymentioning

confidence: 99%

Ureteroscopy for Treatment of Upper Urinary Tract Stones in Children: Technical Considerations

Gupta

Matlaga

et al. 2014

Curr Urol Rep

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The incidence of pediatric urolithiasis is increasing. While many smaller stones may pass spontaneously, surgical therapy is sometimes warranted. Surgical options include shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy, and open surgery. Ureteroscopy represents a minimally invasive approach, and it is increasingly being used to treat pediatric upper tract calculi. Ureteroscopy is performed under anesthesia and fluoroscopic guidance, with basket extraction or lithotripsy of the calculi. Technical considerations include active or passive ureteral dilatation, the use of ureteral access sheaths for larger stone burdens, and post-operative stent placement. The current pediatric literature suggests high success rates (equal to or surpassing shock wave lithotripsy) and low complication rates. However, concerns remain regarding feasibility in patients with variant anatomies and risk due to intra-operative radiation exposure.

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Ureteroscopy in Pediatric Patients with Spinal Abnormalities

Cited by 13 publications

References 12 publications

Is There Still a Place for Percutaneous Nephrolithotomy in Current Times?

Is There Still a Place for Percutaneous Nephrolithotomy in Current Times?

Retrograde intrarenal surgery for impacted upper ureteral stone in a patient with advanced lumbar scoliosis and lower-extremity development defect: a case report

Ureteroscopy for Treatment of Upper Urinary Tract Stones in Children: Technical Considerations

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