Treatment of upper urinary tract stones with flexible ureteroscopy in children

  • Jing Xiao Department of Urology,Beijing Friendship Hospital,Capital Medical University
  • Xiangyu Wang Department of Urology,Beijing Friendship Hospital,Capital Medical University
  • Jun Li Department of Urology,Beijing Friendship Hospital,Capital Medical University
  • Miaomiao Wang
  • Tiandong Han Department of Urology,Beijing Friendship Hospital,Capital Medical University
  • Caixiang Zhang Department of Urology,Beijing Friendship Hospital,Capital Medical University
  • Yuan Du Department of Urology,Beijing Friendship Hospital,Capital Medical University
  • Gangyue Hao Department of Urology,Beijing Friendship Hospital,Capital Medical University
  • Ye Tian Department of Urology,Beijing Friendship Hospital,Capital Medical University
Keywords: children, upper urinary stones, flexible ureteroscopy, holmium laser

Abstract

Introduction: This single-centre, retrospective study aimed to assess the efficacy and safety of flexible ureteroscopy (FURS) combined with holmium laser lithotripsy in treating children with upper urinary tract stones.

Methods: From June 2014 to October 2015, a total of 100 children (74 boys and 26 girls) with upper urinary tract stones were treated using FURS. A 4.7 Fr double-J stent was placed two weeks before operation. Patients were considered stone-free when the absence of residual fragments was observed on imaging studies. The preoperative, operative, and postoperative data of the patients were retrospectively analyzed.

Results: A total of 100 pediatric patients with a mean age of 3.51±1.82 years underwent 131 FURS and holmium laser lithotripsy. Mean stone diameter was 1.49±0.92 cm. Average operation time was 30.8 minutes (range 15–60). The laser power was controlled between 18 and 32 W, and the energy maintained between 0.6 and 0.8 J at any time; laser frequency was controlled between 30 and 40 Hz. Complications were observed in 69 (69.0 %) patients and classified according to the Clavien system. Postoperative hematuria (Clavien I) occurred in 64 (64.0 %) patients. Postoperative urinary tract infection with fever (Clavien II) was observed in 8/113 (7.1%) patients. No ureteral perforation and mucosa avulsion occurred. The overall stone-free rate of single operation was 89/100 (89%). Stone diameter and staghorn calculi were significantly associated with stone-free rate.

Conclusions: FURS and holmium laser lithotripsy is effective and safe in treating children with upper urinary tract stones.

Published
2018-08-30
How to Cite
Xiao, J., Wang, X., Li, J., Wang, M., Han, T., Zhang, C., Du, Y., Hao, G., & Tian, Y. (2018). Treatment of upper urinary tract stones with flexible ureteroscopy in children. Canadian Urological Association Journal, 13(3). https://doi.org/10.5489/cuaj.5283
Section
Original Research