Ureteroscopy and ureterolithotripsy in children

Roberto Mario Scarpa, Antonello De Lisa, Daniele Porru, Paolo Usai, Enzo Usai

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The literature on pediatric ureteroscopy is still rather scarce both of the large size of intruments employed up to a few years ago and of the limited diffusion of ureteroscopy as a standard urologic procedure. For some years now we have presented our method of approach to the ureter based on thin instruments which are suited to the size of the ureter itself, rather than large instruments requiring preliminary dilatation. We have performed both diagnostic and operative ureteroscopies selecting preferably the 7 F Gautier ureteroscope in the first cases, the 9,5 F in one case, and in the last cases the latest ultrathin 4,8 F instruments. In one case we have used, togheter with the Gautier instrument, an ultrathin flexible ureteroscope, the omegascope. Sometimes we used the 8 F Lithoclast ureteroscope. The lithotripters employed were: Pulsolith Dye laser, Lithoclast Ballistic Lithotripter, Sunrise SL 210 Holmium-YAG laser. In the video we present two cases that well illustrate our approach. Our experience totals 11 cases, in all cases treated, we have selected thin instruments, and we have placed an indwelling double pigtail catheter for at least one week post-operatively, in order to preserve the ureteral meatus and uretero-vestical junction from the risk of scarring which could have resulted from undetected traumatic maneuvers occurring during the procedure. In codusionwe may state that ureteroscopy and ureterolithotripsy can be performed safely on pediatric patients by selecting preferably thin or ultrathin instruments and atraumatic power sources such as lasers or ballistic lithotripters. It is however essential for the operator to be particularly experienced, since the structures which have to be negotiated, such as the urethra in boys and the ureterovescteal junction are very fragile, and the risk of iatrogenic damage is always present.

Original languageEnglish
Pages (from-to)362
Number of pages1
JournalBritish Journal of Urology
Issue numberSUPPL. 2
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Urology


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