Document Detail


Ureteroscopy for pediatric urolithiasis: an evolving first-line therapy.
MedLine Citation:
PMID:  15667882     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To present in a retrospective report a contemporary series of patients aged 14 years and younger who were treated for stones with ureteroscopy at our institution from 1991 to 2002. With the improvement and miniaturization of ureteroscopes and ancillary instruments, the endoscopic treatment of renal and ureteral calculi in children has become more feasible. METHODS: A retrospective chart review was performed of 23 patients aged 14 years and younger who had undergone ureteroscopy for the treatment of ureteral or renal calculi at our institution. RESULTS: A total of 27 stones were treated in 23 patients. Of the 27 stones, 18 were in the distal ureter, 5 in the mid ureter, 2 in the proximal ureter, and 2 in the renal pelvis. Ureteral dilation was performed in 4 (17.4%) of the 23 patients. The lithotripsy modalities used were holmium:yttrium-aluminum-garnet laser in 16 (69.6%), electrohydraulic lithotripsy in 3 (13%), a combination of holmium laser and electrohydraulic lithotripsy in 2 (8.7%), and basket extraction alone in 2 (8.7%) of 23 patients. Ureteral stents were placed in 21 (91.3%) of 23 patients. The average operative time was 46.9 minutes (range 15 to 92). In 21 (91.3%) of 23 patients, postoperative imaging was available and revealed that 20 (95.2%) of the 21 patients were rendered stone free. Two patients were lost to follow-up. No intraoperative complications occurred. One patient was treated postoperatively with intravenous antibiotics for transient fever. CONCLUSIONS: Ureteroscopy is safe and effective in the management of ureteral and renal calculi in children. In our institution, it has emerged as a valid first-line therapy for the treatment of pediatric urolithiasis.
Authors:
A H H Tan; M Al-Omar; J D Denstedt; H Razvi
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Urology     Volume:  65     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-25     Completed Date:  2005-09-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  153-6     Citation Subset:  IM    
Affiliation:
Division of Urology, Department of Surgery, University of Western Ontario, London, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Apatites / analysis
Calcium Oxalate / analysis
Child
Child, Preschool
Cystine / analysis
Equipment Design
Female
Humans
Infant
Kidney Calculi / chemistry,  etiology,  surgery
Male
Metabolism, Inborn Errors / complications
Miniaturization
Retrospective Studies
Stents
Treatment Outcome
Ureteral Calculi / chemistry,  etiology,  surgery*
Ureteroscopes
Ureteroscopy*
Uric Acid / analysis
Chemical
Reg. No./Substance:
0/Apatites; 25454-23-3/Calcium Oxalate; 56-89-3/Cystine; 69-93-2/Uric Acid
Comments/Corrections
Comment In:
J Urol. 2005 Oct;174(4 Pt 1):1447-8   [PMID:  16145465 ]

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


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