While paediatric ureteroscopy has been increasingly performed, the evidence for its use in paediatric lower pole stones (LPS) is sparce. In this study we look at the effectiveness and outcomes of flexible ureteroscopy and lasertripsy (FURSL) in the management of LPS for a paediatric population.
Data were collected from two large European tertiary endourology centres which specialise in paediatric kidney stone management. The study was registered as an audit at the respective hospitals. All data were cross-checked and analysed using electronic operative notes, discharge records, laboratory systems and patient correspondence. The inclusion criteria were patients 16 years with lower pole stones having a FURSL procedure.
A total of 57 paediatric patients underwent FURSL for LPS. The mean age was 10.1 years + 4.7 (range: 1-16.9 years) with a male:female ratio of 2:3. The mean single stone size was 9.45+3.9 mm (range: 3-20 mm) and 31(54.4%) had multiple stones. A pre-operative stent was present in 18(31.6%) patients and a post-operative stent or ureteric catheter was left behind in 32(56.1%) patients. The initial and final SFR was 82.4% and 98.2% respectively with 1.19 procedures per patient performed to be stone free. While there were no intra-operative complications, there were only four(7%) minor complications (Clavien I) noted which were all simple urinary infections. No long-term complications were noted.
Flexible ureteroscopy and lasertripsy achieves excellent outcomes for treatment of paediatric LPS. While some patients might need a second procedure for complete stone clearance, FURSL may be considered as the first-line treatment of lower pole stones.
Journal of endourology. 2021 May 18 [Epub ahead of print]
Lucia Mosquera, Amelia Pietropaolo, Yesica Quiroz Madarriaga, Erika Llorens de Knecht, Patrick Jones, Anna Bujons Tur, Stephen Griffin, Bhaskar K Somani
University Hospital Southampton NHS Foundation Trust, 7425, Urology, Southampton, Southampton , United Kingdom of Great Britain and Northern Ireland; ., University Hospital Southampton NHS Foundation Trust, 7425, Urology, Southampton, Southampton , United Kingdom of Great Britain and Northern Ireland; ., Fundació Puigvert, 16444, Cartagena 304, Barcelona, Spain, 08025; ., Fundacio Puigvert, 16444, Pediatric Urology, Barcelona, Catalunya, Spain; ., University Hospitals Bristol NHS Foundation Trust, 1984, Urology, bristol urological institute, Bristol, United Kingdom of Great Britain and Northern Ireland, BS1 3NU; ., Fundacio Puigvert, 16444, Pediatric Urology, Barcelona, Catalunya, Spain; ., University Hospital Southampton NHS Foundation Trust, 7425, Paediatric Urology, Southampton, Southampton , United Kingdom of Great Britain and Northern Ireland; ., University Hospital Southampton NHS Foundation Trust, 7425, Urology, Southampton, Southampton , United Kingdom of Great Britain and Northern Ireland.