Microureteroscopy in the treatment of upper urinary tract stones in pediatric patients younger than 3years of age.

Abstract

The aim of this study is to evaluate the usefulness of microureteroscopy (m-URS) in the treatment of renal and ureteral stones in children younger than 3years of age. A retrospective analysis of pediatric patients aged < 3years with upper urinary tract calculi who underwent lithotripsy was performed. The children were divided into the m-URS group (4.85 F, n = 41) and the ureteroscopy (URS) group (4.5/6.5 F, n = 42) according to the type of ureteroscope used. The mean age of the patients was 23.5 ± 10.7months in the m-URS group and 20.6 ± 7.1months in the URS group (P = 0.212). The success rate of one-stage surgery was 80.5% (33/41) for m-URS and 38.1% (16/42) for URS (P < 0.001). The success rates of m-URS were 60.0%, 69.2%, and 91.3% for stones located in the renal pelvis/calix, upper ureter, and mid-lower ureter, respectively. Eight children in the m-URS group and 26 children in the URS group underwent the second-stage ureteroscopic surgery. The mean operation time was 50 (30-60) min in the m-URS group and 40 (34-60) min in the URS group (P = 0.287). The complication rates were 4.9% and 7.1% in the m-URS and URS groups, respectively (P = 1.000). The stone-free rate at 1 month after lithotripsy was 87.8% in the m-URS group and 83.3% in the URS group (P = 0.563). The mean anesthesia session was 2.1 in the m-URS group and 2.5 in the URS group (P = 0.002). M-URS can effectively reduce the number of anesthesia sessions and is considered an alternative treatment for upper urinary tract calculi in selected pediatric patients younger than 3years of age.