Experience with ureteroscopy in children

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Abstract
To present our experience of ureteroscopic procedures in children using miniaturized instrumentation. Fourteen children aged between 13 months and 14 years underwent 20 ureteroscopic procedures. Semi-rigid 7.2 F and flexible 9.5 F ureteroscopes were used in a retrograde and an antegrade fashion. Eighteen ureteroscopies were performed retrogradely and two antegradely. Of the 20 ureteroscopic procedures, 18 were for stone disease, one for haematuria of unknown origin and one for removal of a migrated stent. The average size of the stone was 12.9 x 6.6 mm. Access using miniaturized ureteroscopes was successful in all patients. Dilatation was required only in 1 of 20 procedures. The management of stone disease in 10 of 13 children was straightforward and a single ureteroscopy was required to clear the ureters. In three of 13 children with stone disease the problems were more complex and nine ureteroscopies were undertaken to render the ureters stone free. Complications were stricture at the site of stone impaction (one patient), retention of urine due to a stone fragment in the urethra (one patient), haematuria (one patient) and migrated stent requiring ureteroscopy (one patient). In the hands of an experienced surgeon ureteroscopy can be used with equal success in children as in adults to treat calculus disease.