Minimally Invasive Treatment Of Ureteral Calculi In Children
April 12, 2007 – 3:02 pm | posted in Pediatrics, Urology / NephrologyUroToday.com- A study by Tan, et al evaluated minimally invasive treatment of ureteral calculi in children. They retrospectively reviewed the efficacy of shock wave lithotripsy and ureteroscopy in the treatment of pediatric ureteral calculi. They reviewed the records of 67 children. Thirty-five of these patients were boys and 32 were girls. They had a total of 71 ureters. Their review was over a 15 year span from 1990-2005. The initial treatment method was shock wave lithotripsy and 80.3% (57 ureters). Ureteroscopy was performed in 11.3% (8 ureters). They performed open surgery in 8.5% of the cases (6 ureters). The mean age of the patients was 10.67 ± 4.4 years with a range of 1-16 years. The stone free rates after shock wave lithotripsy for upper, middle and lower ureteral calculi were 74.1, 100 and 75.9% respectively. Increased stone diameter and/or stone burden were found to be significant factors that had adverse affects on stone-free rates after shock wave lithotripsy with stone location not playing a role. When they evaluated ureteroscopy they included 6 patients (7 ureters) that failed shock wave lithotripsy and had a total of 14 patients overall who underwent ureteroscopy for lower ureteral calculi. Lower ureteral calculi found a stone-free rate of 93.3% with one treatment.
The group found that there overall stone free rates after shock wave lithotripsy, ureteroscopy, and open surgery were 75.4, 93.3, and 100% respectively. They concluded that depending on stone burden, shock wave lithotripsy might be a good option for initial treatment of most ureteral calculi in children. They also believed that ureteroscopy offers a high success rate for lower ureteral calculi which included shock wave lithotripsy failure.
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