Pneumatic ureterolithotripsy in paediatric and adolescent patients: a ten-year experience at the Hospital Universiti Sains Malaysia

Hussein NS, Gohar MR
Correspondence: Dr Naser Sabah Hussein, dr_nasser73@yahoo.com

ABSTRACT
Introduction Two to three percent of stone disease cases occur in the paediatric age group. It is common in some parts of the world, such as in Turkey, India and Thailand. More than 50 percent of stones in children are still managed through open surgery. Ureteroscopic intervention for children remains a challenging treatment option. However, in contemporary urology practice, this mode of intervention is becoming more common. In this retrospective study, we reviewed our experiences with ureteroscopy and pneumatic lithotripsy in the paediatric and adolescent age group.
Methods A total of 13 patients at or below the age of 18 years underwent 17 retrograde semirigid ureteroscopy between 1998 and 2008. Their median age was 14 (range 3–18) years. The technique of ureterolithotripsy used for this age group was similar to that used among adults. The ureteric orifice and intramural part of the ureter were not dilated in all the patients. A double J stent was inserted into all the patients.
Results The mean stone size was 7.9 (range 5–13) mm. The stone was in the distal ureter in eight patients, in the mid ureter in seven patients and at the ureterovesical junction in another two patients. The overall stone-free rate after one ureterolithotripsy procedure was 84.6%. We failed to clear the stones in two patients at the first sitting.
Conclusion Semi-rigid ureteroscopy and pneumatic ureterolithotripsy are safe and effective procedures that and can be performed without ureteric dilation in experienced hands.

Keywords: paediatric lithotripsy, pneumatic lithotripsy, ureteroscopy, urolithiasis
Singapore Med J 2011; 52(1): 42-46