Minimally invasive approach for paediatric ureteric calculi

ABSTRACT

To find out the efficacy and safety of ureteroscopy in the management of paediatric ureteric calculi in terms of stone clearance rate and hospital stay. Descriptive study. Department of Urology Chandka Medical College Larkana, From January 2006 to October 2008. All children with ureteric calculi were thoroughly examined. Blood CP, blood urea, serum creatinine, ultrasound KUB and IVP were carried out in all. They underwent URS. 8.5 FR [Wolf] ureteroscope was used. Stones were broken down with Swiss lithoclast There was no rigid protocol for placement of ureteric stent but ureteric catheter was placed in all. Follow up x-ray KUB was done in all the children to find out the clearance of stone fragments. During the study period nineteen children with mean age of 7 years [range - 5 year to 12 years] having ureteric calculi of 7 mm to 1.2 cm [average size - 1cm] were managed. In most of the cases the stone were in the lower one third of the ureter. Presenting symptoms were abdominal pain in 7 [36.84%], dysuria in 4 [21.05%], haematuria in 3 [15.79%] and recent episodes of urinary tract infection in 5 [26.32%] children respectively. In 10 [50.54%] calculi were on right side. In 17 patients stones were located in lower 1/3 while in 2 patients stones were present in both the ureters. In two patients repeat ureteroscopy was required as initially ureteroscope could not be negotiated hence ureteric catheter was left for 48 hours. Successful stone clearance was achieved in 95%. One child developed haematuria. No long term complication was found during the study. Ureteroscopy is safe and effective management for ureteric calculi in children