Endoscopic Treatment of Children With Impacted Ureteral Stones
Ureteroscopy is the method of choice for treating children with impacted ureteral stones. In this study, ureterolithotripsy were used to assess the treatment outcomes for pediatric patients with impacted ureteral stones. The treatment results of 73 children aged 5 to 18 years were retrospectively evaluated. The average stone size was 10.0 ± 0.6 mm in length and 5.5 ± 0.7 mm in width. Complete stone removal was achieved in 71 patients (97.2%). The total number of intraoperative complications was 24 (33.8%). Conversion from endoscopic intervention to open surgery was required in two cases (2.8%) (Grade III). Ureteral mucosal injury was observed in 6.8% of children (Grade I), and ureteral perforation in 1.4% of cases (Grade II-a). Ureteral mucosal burns occurred in 4.1% of patients (Grade II-a) during laser lithotripsy. Deformation of the tip of the metal guidewire during an attempt to pass it retrogradely into the kidney occurred in 16.4% of cases (Grade I). Postoperative complications were observed in 23 patients (31.5%). Elevated body temperature was noted in 8.2% of cases (Grade I), and hematuria in 9.6% (Grade I). Urinoma (Grade III-b) and steinstrasse (Grade II-a) were each observed in one child (1.4%). Systemic inflammatory response syndrome was also reported in one case. Ureteroscopic contact lithotripsy for impacted ureteral stones in children is an effective and safe treatment method
