Ureteroscopic Stone Management in Prepubertal Children

Introduction: We retrospectively assessed our experience with ureteroscopy (URS) for ureteric calculi in prepubertal children. Patients and Methods: The records of all children who underwent URS at our institution for ureteral calculi between September 2007 and July 2009 were retrospectively reviewed. Patient demographics, stone location and size, pre- and postoperative stenting, intraoperative active dilatation, stone-free rates and complications were noted. Results: A total of 26 patients (20 males and 6 females; mean age 59.9 months) underwent 30 URS procedures with rigid ureteroscopes for 31 ureteral calculi. The mean size of ureteral stones was 8.6 mm. A total of 18 URS procedures were performed without any active ureteral dilatation, and 8 patients underwent 12 passive dilatations of initially inaccessible ureters. Stents remained in place for 2–4 weeks. The stone-free rate was 84.6% for all patients and all procedures. Postoperatively, 12 patients (46%) had stent placement for 2–5 days because of stone burden, edema of the ureteral orifice and hematuria. Conclusions: URS treatment of ureteral stones without active dilatation can be performed safely and effectively in prepubertal children. Passive ureteral dilatation might be necessary in some cases to enable ureteral access.