Aims: The use of ureteroscopy in treating paediatric stone disease has risen in recent years. We retrospectively reviewed the results of ureteroscopic stone management for our regional paediatric stone service. Material and Methods: Between April 2010 and October 2013, consecutive patients undergoing ureteroscopy and stone fragmentation were identified. Data were recorded from electronic records for patient demographics, pre-operative assessment, stone characteristics, and intra- and post-operative complications. Results: Twenty-one patients (mean age 8.6 years; range: 1.4-16) had 32 procedures in our series (13 males and 8 females). Five (24%) had a metabolic abnormality and 8 (38%) had an anatomical abnormality. The mean initial stone size was 9.6 mm (range: 5-20) and 10 were left sided. Of the 32 procedures, 18 (56%) had a pre-operative stent. A positive pre-operative urine culture was seen in 4 (13%). CT was used in 6 (19%) with the rest having a combination of USS and/or plain KUB. Of these 21 patients, 13 (62%) were stone free after the first procedure, 17 (81%) after a second and 20 (95%) after a third (mean 1.5 procedures/patient). One patient with a 6-mm residual fragment chose to have surveillance. Eighteen (50%) had post-operative stent insertion. The mean length of stay was 1.5 days (range: 0-5). A minor complication (Clavien 1) was observed in 1 patient. No other complications were recorded. Conclusions: Ureteroscopy for stone disease in children is feasible with a low complication rate and high stone-free rate.

Keywords:
Ureteroscopy, Urolithiasis, Outcome, Laser, Calculi
1.
Salerno A, Nappo SG, Matarazzo E, De Dominicis M, Caione P: Treatment of pediatric renal stones in a Western country: a changing pattern. J Pediatr Surg 2013;48:835-839.
2.
VanDervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, Trachtman H: Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol 2007;177:2300-2305.
3.
Kairam N, Allegra JR, Eskin B: Rise in emergency department visits of pediatric patients for renal colic from 1999 to 2008. Pediatr Emerg Care 2013;29:462-464.
4.
Sas SJ, Hulsey TC, Shatat IF, Orak JK: Increasing incidence of kidney stones in children evaluated in the emergency department. J Pediatr 2010;157:132-137.
5.
Lao M, Kogan BA, White MD, Feustel PJ: High recurrence rate at 5-year followup in children after upper urinary tract stone surgery. J Urol 2014;191:440-444.
6.
Onal B, Citgez S, Tansu N, Emin G, Demirkesen O, Talat Z, Yalcin V, Erozenci A: What changed in the management of pediatric stones after the introduction of minimally invasive procedures? A single-center experience over 24 years. J Pediatr Urol 2013;9:910-914.
7.
Erkurt B, Caskurlu T, Atis G, Gurbuz C, Arikan O, Pelit ES, Altay B, Ergodan F, Yildirim A: Treatment of renal stones with flexible ureteroscopy in preschool age children. Urolithiasis 2014;42:241-245.
8.
Abhishek, Kumar J, Mandhani A, Srivastava A, Kapoor R, Ansari MS: Pediatric urolithiasis: experience from a tertiary referral center. J Pediatr Urol 2013;9:825-830.
9.
Routh JC, Graham DA, Nelson CP: Trends in imaging and surgical management of pediatric urolithiasis at American pediatric hospitals. J Urol 2010;184(suppl 4):1816-1822.
10.
Riccabona M, Avni FE, Blickman JG, Dacher JN, Darge K, Lobo ML, Willi U: Imaging recommendations in paediatric uroradiology: minutes of the ESPR uroradiology task force session on childhood obstructive uropathy, high-grade fetal hydronephrosis, childhood haematuria and urolithiasis in childhood. Pediatr Radiol 2009;39:891-898.
11.
Turk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M, Seitz C: EAU guidelines on urolithiasis. 2013. http://www.uroweb.org/gls/pdf/21_Urolithiasis_LR.pdf (accessed February 15, 2014).
12.
Johnson EK, Graham DA, Chow JS, Nelson CP: Nationwide emergency department imaging practices for pediatric urolithiasis patients: room for improvement. J Urol 2014;192:200-206.
13.
Mathews JD, Forsythe AV, Brady Z, Butler MW, Goergen SK, Byrnes GB, Giles GG, Wallace AB, Anderson PR, Guiver TA, McGale P, Cain TM, Dowty JG, Bickerstaffe AC, Darby SC: Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ 2013;346:f2360.
14.
Bastug F, Gunduz Z, Tulpar S, Poyrazoglu H, Dusunsel R: Urolithiasis in infants: evaluation of risk factors. World J Urol 2013;31:1117-1122.
15.
Milosevic D, Batinic D, Turudic D, Batinic D, Topalovic-Grkovic M, Gradiski IP: Demographic characteristics and metabolic risk factors in Croatian children with urolithiasis. Eur J Pediatr 2014;173:353-359.
16.
Rellum DM, Feitz WF, van Herwaarden AE, Schreuder MF: Pediatric urolithiasis in a non-endemic country: a single center experience from The Netherlands. J Pediatr Urol 2014;10:155-161.
17.
Koyuncu H, Yencilek F, Erturhan S, Eryildirim B, Sarica K: Clinical course of pediatric urolithiasis: follow-up data in a long-term basis. Int Urol Nephrol 2011;1:7-13.
18.
Ishii H, Griffin S, Somani BK: Flexible ureterorenoscopy and lasertripsy (FURSL) for paediatric renal calculi: results from a systematic review. J Pediatr Urol 2014;10:1020-1025.
© 2015 S. Karger AG, Basel
2015
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.