Abstract
Pediatric ureteroscopy has been increasingly used to manage both ureteral and renal stones. Unfortunately, there are no current standardized recommendations when treating pediatric stone disease so the modality chosen is left to the treating surgeon. A review of the current literature on pediatric ureteroscopy was used to compile this article. For the purposes of this review, the majority of series include stones ≤1 cm. Ureteroscopy is considered to be first-line therapy in treating mid- to distal ureteral stones and is rapidly evolving as an acceptable first-line therapy for renal stones as well. Limitations do exist and include stone composition, location, size, as well as the unique anatomic challenges faced by pediatric urologists in terms of anomalous kidneys and/or reconstructed urinary tracts. In conclusion, ureteroscopy can be considered first-line therapy for mid- or distal ureteral stones, however, it shares a similar efficacy rate as extracorporeal shock wave lithotripsy for the treatment of renal calculi. There is a need for direct comparison in the literature of all modalities treating pediatric stone disease to facilitate guidelines that help treating surgeons choose the most efficacious modality offering the highest success rates with the lowest morbidity.
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References
Smaldone M, Corcoran AT, Docimo SG, Ost MC (2009) Endourological management of pediatric stone disease: present status. J Urol 181:17–21
Schuster TG, Russell KY, Bloom DA, Koo HP, Faerber GJ (2002) Ureteroscopy for the treatment of urolithiasis in children. J Urol 167:1813–1816
Tan AH, Al-Omar M, Denstedt JD, Razvi H (2005) Ureteroscopy for pediatric urolithiasis: an evolving first-line therapy. Urology 65:153–156
Minevich E, Sheldon CA (2006) The role of ureteroscopy in pediatric urology. Curr Opin Urol 16:29–295
Thomas JC, DeMarco RT, Donohoe JM, Adams MC, Pope JC IV, Brock JW III (2005) Pediatric ureteroscopic stone management. J Urol 174:1072–1074
Lesani OA, Palmer JS (2006) Retrograde proximal rigid ureteroscopy and pyeloscopy in prepubertal children: safe and effective. J Urol 176:1570–1573
Smaldone MC, Cannon GM Jr, Wu HY, Bassett JC, Bellinger MF, Docimo SG, Schneck FX (2007) Is ureteroscopy first-line treatment for pediatric stone disease? J Urol 178:2128–2131
Kim SS, Kolon TF, Canter D, White M, Casale P (2008) Pediatric flexible ureteroscopic lithotripsy: the children’s hospital of Philadelphia experience. J Urol 180:2616–2619
Cannon GM Jr, Smaldone MC, Wu HY, Bassett JC, Bellinger MF, Docimo SG, Schneck FX (2007) Ureteroscopic management of lower-pole stones in a pediatric population. J Endourol 21:1179–1182
Tanaka ST, Makari JH, Pope JC IV, Adams MC, Brock JW III, Thomas JC (2008) Pediatric ureteroscopic management of intrarenal calculi. J Urol 180:2150–2153
Hubert KC, Palmer JS (2005) Passive dilation by ureteral stenting before ureteroscopy: eliminating the need for active dilation. J Urol 174:1079
Corcoran AT, Smaldone MC, Mally D, Ost MC, Bellinger MF, Schneck FX, Docimo SG, Wu HY (2008) When is prior ureteral stent placement necessary to access the upper tract in prepubertal children? J Urol 180:1861–1863
Vanlangenonck R, Landman J (2004) Ureteral access strategies: pro-access sheath. Urol Clin N Am 31:71–81
Abrahams HM, Stoller ML (2004) The argument against the routine use of ureteral access sheath. Urol Clin N Am 31:83–87
Delvecchio FC, Auge BK, Brizuela RM, Weiaer AZ, Silverstein AD, Lallas CD, Pietrow PK, Albala DM, Preminger G (2003) Assessment of stricture formation with the ureteral access sheath. Urology 61:518–522
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Proceedings paper from the 3rd International Urolithiasis Research Symposium, Indianapolis, Indiana, USA, 3–4 December 2009.
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Thomas, J.C. How effective is ureteroscopy in the treatment of pediatric stone disease?. Urol Res 38, 333–335 (2010). https://doi.org/10.1007/s00240-010-0293-2
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DOI: https://doi.org/10.1007/s00240-010-0293-2