[Minimally invasive endourological management of urinay tract calculi in children].

BACKGROUND

The urinary tract calculi in children is a very unfrequent problem in the pediatric age group. Endourology plays a major role in pediatric surgery. We reported our experience in endoscopic management of pediatric calculi.

METHODS

Eighteen children (age range: 2 year-19 years) underwent endourology procedures for extraction of urinary tract lithiasis in the period from 1992 until 2006. We reviewed retrospectively the following features: calculi size, location, procedures, surgical complications, recurrent, results and time of follow-up.

RESULTS

Twenty-one endourolgy procedures were performed: nine ureteroscopies (43%), 10 bladder extractions (47.5%) and two percutaneous nephrolithotomies (9.5%). The mean size bladder stone was 2.75 cm. and 6.3 mm. in the ureteral stones. A patient had staghorn calculi. The stone was located in distal ureter in 7 occasions (33.3%), in upper ureter in 2 (9.5%), in kidney in 2 (9.5%), in bladder in 9 (43%) and in urethra in one (4.7%). Ten cases (55.5%) had urology associated anomalies: 6 patients neurogenic bladder, two bladder exstrophy, one ureterocele and one diagnosed of primary megaureter. Four patients (22%) underwent open surgery for the extraction of the lithiasis: a patient with a bladder stone and three cases with ureteral calculi. Three patients (16, 5%) had recurrence of stones and were successfully treated with endoscopy procedure again. By the moment all the patients are stone-free. The time of follow-up has been 2 years and 6 months (range: 1-13 years).

CONCLUSIONS

The endourology is a safe and effective therapeutic option for the management of urinary tract calculi in children. With improvements in instrumentation and technology, it will be possible to expand the patients' selection criterion.