Semi-rigid ureterorenoscopy in children without ureteral dilatation

Abstract

We aimed to retrospectively review the efficiency of ureterorenoscopy (URS) applied without ureteral dilatation for evaluating pediatric ureteral pathologies. The files of pediatric patients hospitalized in our clinic between January 2000 and June 2006 due to ureteral stone disease were reviewed and evaluated retrospectively. The ages, medical histories, physical examination results, preoperative routine blood and urinary tests, and culture results were recorded. Ureteral orifice dilatation was not needed in any of the patients. Due to the risk of mucosal trauma and edema development in the ureteral orifice and intramural ureter, 3F and 4F catheters were applied in all patients following the ureterorenoscopy. These catheters were removed 24 h after the procedure. The files of 54 pediatric patients with a mean age of 8.5 years (range 1-16 years) were evaluated retrospectively. While diagnostic URS was applied in 12 (22.2%) of the patients, ureteral calculi were determined in 42 (77.8%) patients and the stones were fragmented by pneumatic lithotripter. Twenty-five of the stones were localized in the lower ureter, 16 in the mid-ureter, and 3 in upper ureter. The mean stone size was found to be 7.1 mm (range 4-12). None of the stones migrated to the proximal region. In 2 patients open ureterolithotomy was applied; stones were localized in the upper ureter in both of these patients. Ureterorenoscopy can be successfully and safely applied without the need for ureteral dilatation in ureteral pathologies of children.