Ureteroscopy for Paediatric Renal Tract Stones - Outcomes from a Tertiary European Centre.

ABSTRACT

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.