Pediatric endourology

Objective: To assess the outcome of pediatric patients treated by an endourological approach for various urinary tract pathologies. Methods and Materials: Thirty-seven children (median age 5 years, range 0.3-14 years) were endoscopically treated for ureteropelvic junction obstruction (UPJO) (n=6), ureteral strictures (n=5), upper urinary tract calculi (n=21) and bladder calculi (n=5). Result: Upper urinary tract calculi were approached by ureteroscopy (n=12), retrograde intrarenal surgery (n=6) and percutaneous nephrolithotomy (n=3). The average stone burden was 11 mm (range 5-35 mm) and operative time was 40 minutes (range 15-120 minutes). Bladder calculi were treated percutaneously in 3 cases and transurethrally in 2 cases for an average stone burden of 34 mm (range 7-120 mm). The overall stone-free rate after one procedure was 96%. UPJOs were retrogradely approached in an average operative time of 40 minutes (range 30-50 minutes). Successful clinical and functional outcome was maintained after an average follow-up of 15 months (range 6-30 months). The 5 ureteral strictures included 2 located in the middle ureter and 3 at the ureterovesical junction. The success rate in this group was 80% and the average follow-up 24 months (range 6-40 months). The median hospitalization time for the entire series was 1 day (range 0-7 days). There were no intraoperative complications. Three (8%) patients developed post-operative urinary tract infections. Delayed anterior urethral stricture occurred in 1 case. No additional complications occurred after an average follow-up of 11 months (range 4-36 months). Conclusion: Endourology in children is safe and highly effective. It appears that the indications for endourological treatment in children emulate those of adults.