Document Detail

Retrograde ureteroscopy for distal ureteric stone removal in children.
MedLine Citation:
PMID:  15839930     Owner:  NLM     Status:  MEDLINE    
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.
Mauro De Dominicis; Ennio Matarazzo; Nicola Capozza; Giuseppe Collura; Paolo Caione
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  BJU international     Volume:  95     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-20     Completed Date:  2005-05-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1049-52     Citation Subset:  IM    
Division of Paediatric Urology, Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Research Institute, Rome, Italy.
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MeSH Terms
Child, Preschool
Length of Stay
Lithotripsy / methods*
Ureteral Calculi / diagnosis,  therapy*
Ureteroscopy / methods*
Comment In:
Nat Clin Pract Urol. 2005 Nov;2(11):532-3   [PMID:  16474594 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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