Ureteroscopic Treatment Of Urinary Lithiasis In The Pediatric Population

Jonathan Mobley, Stanley J Kandzari, Stanley Zaslau, William Tarry*
West Virginia University, Morgantown, WV

Introduction: We review the efficacy, complication rate, and surgical trends of ureteroscopic intervention for patients younger than eighteen years of age.
Methods: A five-year retrospective analysis of all patients under eighteen years of age that underwent ureteroscopic treatment of urinary tract stones was reviewed.
Results: Eleven ureteroscopic interventions were performed on 11 patients under eighteen years of age. Included were 8 males (73%) and 3 females (27%), with a mean age of 11.9 years. Nine patients (81%) had ureteroscopy as the primary treatment, one (9%) had a prior ESWL, and another (9%) had multiple prior procedures. Twelve stones were noted in ten of the eleven patients with locations as follows: 1(9%) lower pole, 2(18%) proximal ureter, 1(9%) midureter, and 7(64%) distal ureter. In 45% of the cases, a ureteral stent was placed prior to the date of ureteroscopy. A rigid ureteroscope was used in 64%, a flexible ureteroscope in 27%, and 9% of the cases used both a rigid and flexible scope. Ureteral stents were placed post ureteroscopy in 91% of the cases. 55% of the patients were followed for a mean of 2.9 months (range 1 week to 5 months). Of the eleven patients, ten (91%) had complete resolution of their stone with a single definitive intervention.
Conclusions: The success of ureteroscopy is related to the number of calculi in the collecting system. Early post-operative complications were minimal. Longer follow up intervals are required to understand incidence of late complications.

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