Document Detail


Ureteroscopy in the management of pediatric urinary tract calculi.
MedLine Citation:
PMID:  15798409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report our experience with ureteroscopy in the treatment of pediatric urinary tract calculi and present a review of the literature. PATIENTS AND METHODS: Between 1988 and 2003, 52 ureteroscopic procedures were performed in 25 male and 10 female children aged 11 months to 15 years (mean 5.9 years). Using a semirigid 6.8F 43-cm ureteroscope and routine antibiotic prophylaxis, stones were fragmented with a pulsed-dye laser (N = 14; stone size 6-15 mm with a mean of 9.6 mm), electrohydraulic lithotripsy (EHL) (N = 26; stone size 3-20 mm with a mean of 8.4 mm), or a holmium laser (N = 7; stone size 5-15 mm with a mean of 10 mm); removed by basket extraction (N = 5; stone size 5-8 mm with a mean of 7 mm); or both. Stenting or ureteral dilatation was not performed routinely. RESULTS: With the pulsed-dye laser, there was an overall stone-free rate of 72%. Complications consisted of one ureteral perforation and one stenosis of the intramural portion of a megaureter (14% complication rate). With EHL, the overall stone-free rate was 92%. Complications consisted of one case each of ureteral perforation and incipient urinary retention and five of mild fever (27%). With the holmium laser, the overall stone-free rate was 100%, and there were no complications. Basketing likewise produced a 100% stone-free rate, and there was one complication, a mucosal tear in a patient who also underwent pulsed-dye laser lithotripsy. CONCLUSION: Ureteroscopy is a safe and effective means of treating the majority of pediatric ureteral calculi, although retreatment rates are higher with multiple stones and in younger children. Dilatation of the vesicoureteral junction is usually not necessary with ureteroscopes <8F, nor is ureteral drainage required after uncomplicated ureteroscopy. The holmium laser is the most effective and safest method of fragmentation regardless of stone composition. Ureteroscopy for this indication should be performed only by an experienced endoscopist.
Authors:
Asif Raza; Gordon Smith; Sami Moussa; David Tolley
Related Documents :
1754769 - Edap lt-01 piezoelectric lithotriptor.
11060189 - Long-term follow-up after treatment of mirizzi syndrome by peroral cholangioscopy.
8578269 - Recurrence rates and severity of urinary calculi.
10524919 - Percutaneous management of renal calculi: experience with percutaneous nephrolithotomy ...
10619939 - A randomized trial comparing lithoclast with an electrokinetic lithotripter in the mana...
3596979 - Extracorporeal shock wave lithotripsy (eswl).
9725529 - Temporomandibular joint dysfunction in children: evaluation of treatment.
22036839 - Modified lund concept versus cerebral perfusion pressure-targeted therapy: a randomised...
1754769 - Edap lt-01 piezoelectric lithotriptor.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  19     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-30     Completed Date:  2005-05-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-8     Citation Subset:  IM    
Affiliation:
The Scottish Lithotriptor Centre, Western General Hospital, Edinburgh, Scotland, UK. araza36624@aol.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Antibiotic Prophylaxis
Child
Child, Preschool
Female
Humans
Infant
Laser Therapy*
Lithotripsy / adverse effects,  methods*
Male
Reoperation
Treatment Outcome
Ureteroscopes
Ureteroscopy*
Urinary Calculi / therapy*

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


Previous Document:  Febrile complications following insertion of 100 double-J ureteral stents.
Next Document:  Minimally invasive therapy for benign prostatic hyperplasia: practice patterns in Minnesota.