Pediatric ureteroscopy in underprivileged preschool patients: Single-center perspective

Abstract

Background: The incidence of stone disease in the pediatric age group dramatically increased in developing countries like Sudan. Despite, the challenges in the management of ureteral stone in the aforementioned age group, ureteroscopy (URS), lithotripsy using Holmium Laser (HO) has been reported as standard effective and safe. The aim of this study is to assess the outcome of URS lithotripsy using HO in preschool patients younger than 5 years of age. Materials and Methods: The results of treatment in 42 patients, who had undergone intervention for ureter stones at Gezira Hospital for Renal Disease and Surgery-Sudan, were prospectively evaluated. Miniscopes with an HO were used for lithotripsy. Results: The mean patient's age was 2.5 ± 1.2 years (1–4 years). The success rate was 69.9% after an average follow-up of 16 months (range 10–24). The majority 81% (n = 34) of study cases were presented with ureteric stones, which comprised 52.4% (n = 22) unilateral and 28.6% (n = 12) bilateral. The cases of unilateral and bilateral stricture include 6 and 2 cases, respectively. After the procedure, the ureteric stenting (double J) was used in 81% of the cases. The perioperative complication rate was 31.0%, and the most common complication was a failure of cannulation followed by the false passage. The mortality rate was zero. Conclusion: URS is considered safe and effective method for pediatric ureteric stones. The size of ureteroscope has an important role in the outcome and complications.

Keywords

• Gezira Hospital for Renal Disease and Surgery
• pediatric ureteroscopy
• Sudan
• ureteral stone