Canan Kocaoglu1, Keramettin Ugur Ozkan2. 1. Department of Pediatric Surgery, Konya Education and Research Hospital, Konya, Turkey. Electronic address: drckocaoglu@hotmail.com. 2. Division of Pediatric Urology, Department of Pediatric Surgery, Medical Faculty, Sutcu Imam University, Kahramanmaras, Turkey.
Abstract
OBJECTIVE: To evaluate the effectiveness of 4.5F ultrathin semirigid ureteroscope (ultrathin-URS) in the management of ureteral stones in prepubertal children without active or passive ureteral dilatation. MATERIALS AND METHODS: Records of 36 children undergoing ureteroscopy with ultrathin-URS were retrospectively reviewed in 2 different centers for ureteral calculi between November 2011 and December 2013. Stones were fragmented with holmium:yttrium-aluminum-garnet laser and pneumatic lithotripter. Patients' demographics, stone location and size, active dilatation, passive dilatation, postoperative stenting, stone-free rates, and complications were noted. RESULTS: Patients consisted of 21 girls and 15 boys with a mean age of 5.33±3 years. Stones were located in the distal, mid, and proximal ureter in 26, 5, and 5 patients, respectively. All ureteroscopies were performed with no active or passive dilatation. Ultrathin-URS was able to provide a stone-free status in the first procedure except 1 patient whose stone was too proximal. Postoperative ureteral stents (post-stenting) had initially been placed in 16 procedures at the end of the procedure to maintain the ureteral passage. However, after increasing occupational experience and learning that ureteral traumas were minimal with ultrathin-URS, no postoperative stent was used in the following procedures. As to complications, only 3 patients had mild hematuria, and 1 patient had febrile urinary tract infection, and 1 stone migration. No ureteral perforation, obstruction and avulsion were encountered. CONCLUSION: In ureteral stone management, ultrathin-URS along with either holmium:yttrium-aluminum-garnet laser or pneumatic lithotripter can be safely and effectively used with a minimal morbidity as a first-line treatment in prepubertal children without active or passive ureteral dilatation and postoperative stenting.
OBJECTIVE: To evaluate the effectiveness of 4.5F ultrathin semirigid ureteroscope (ultrathin-URS) in the management of ureteral stones in prepubertal children without active or passive ureteral dilatation. MATERIALS AND METHODS: Records of 36 children undergoing ureteroscopy with ultrathin-URS were retrospectively reviewed in 2 different centers for ureteral calculi between November 2011 and December 2013. Stones were fragmented with holmium:yttrium-aluminum-garnet laser and pneumatic lithotripter. Patients' demographics, stone location and size, active dilatation, passive dilatation, postoperative stenting, stone-free rates, and complications were noted. RESULTS:Patients consisted of 21 girls and 15 boys with a mean age of 5.33±3 years. Stones were located in the distal, mid, and proximal ureter in 26, 5, and 5 patients, respectively. All ureteroscopies were performed with no active or passive dilatation. Ultrathin-URS was able to provide a stone-free status in the first procedure except 1 patient whose stone was too proximal. Postoperative ureteral stents (post-stenting) had initially been placed in 16 procedures at the end of the procedure to maintain the ureteral passage. However, after increasing occupational experience and learning that ureteral traumas were minimal with ultrathin-URS, no postoperative stent was used in the following procedures. As to complications, only 3 patients had mild hematuria, and 1 patient had febrile urinary tract infection, and 1 stone migration. No ureteral perforation, obstruction and avulsion were encountered. CONCLUSION: In ureteral stone management, ultrathin-URS along with either holmium:yttrium-aluminum-garnet laser or pneumatic lithotripter can be safely and effectively used with a minimal morbidity as a first-line treatment in prepubertal children without active or passive ureteral dilatation and postoperative stenting.
Authors: Muhammet Fatih Kılınç; Ömer Gökhan Doluoğlu; Tolga Karakan; Ayhan Dalkılıç; Nurettin Cem Sönmez; Cem Nedim Yücetürk; Berkan Reşorlu Journal: Turk J Urol Date: 2016-06
Authors: Arvind P Ganpule; Jaspreet Singh Chhabra; S B Sudharsan; Ankush Jairath; Mohankumar Vijaykumar; Ravindra Sabnis; Mahesh R Desai Journal: Arab J Urol Date: 2017-01-07