OUR RESULTS FOR RIGID URETEROSCOPY AND LASER LITHOTRIPSY IN PEDIATRIC AGE GROUP

Abstract

Objective: Urolithiasis is an important disease that can lead to permanent kidney dysfunction and severe clinical symptoms in pediatric patients. We aimed to present our findings of rigid ureteroscopy combined with Holmium YAG laser lithotripsy.Material and Methods: We retrospectively reviewed the ultrasonography, and medical records of pediatric patients with urolithiasis who were operated in Sutcu Imam University Department of Pediatric Surgery, Kahramanmaraş between April 2018 and December 2019.Results: Sixty-one pediatric patients (M/F=38/23) with urolithiasis were enrolled in this study. The mean age was 6.7±4.9 years (range 3 month-17 years). Thirteen (34.2%) male patients need an urgent operation (rigid ureteroscopy combined with Holmium YAG laser lithotripsy) while the corresponding number was 4 (17.4%) in female patients. The difference between two sexes was statistically non-significant (p=0.156). Thirty-two male patients (84.2%) and 12 (52.2%) females patients had a successful operation (rigid ureteroscopy combined with Holmium YAG laser lithotripsy). The difference between the two sexes was statistically significant (p=0.019). The ratio of female patients with right-sided stone was significantly greater than the corresponding rates of male patients (p=<0.001). There was no difference between infants (<3 years of age) and toddlers (>3 years of age) with respect to gender, side of stone, procedural success, and need for urgent surgery (p>0.05). Regression analysis showed that female gender was a risk factor for a failed attempt (OR=-0.313, 95% CI: 0.052 – 0.528; p=0.0018).Conclusion: Safe and effective stone treatment can be performed considering that more than one operation can be performed in infants and children with mini ureteroscopy and holmium laser. However, while evaluating this treatment option in female patients, alternative treatment methods such as flexible or percutaneous nephrolithotomy may be preferred.