Ureteroscopy in the treatment of paediatric stone disease
Monday, 26 July 2010- Paediatric ureteroscopy has been increasingly used to manage both ureteral and renal stones. Unfortunately, there are no current standardised recommendations when treating paediatric stone disease so the modality chosen is left to the treating surgeon.
J. Thomas conducted a review on current literature and published his findings in the journal Urological Research.
"A review of the current literature on paediatric ureteroscopy was used to compile this article. For the purposes of this review, the majority of series include stones ≤1 cm. Ureteroscopy is considered to be first-line therapy in treating mid- to distal ureteral stones and is rapidly evolving as an acceptable first-line therapy for renal stones as well," Thomas wrote.
Limitations do exist and include stone composition, location, size, as well as the unique anatomic challenges faced by paediatric urologists in terms of anomalous kidneys and/or reconstructed urinary tracts.
In his conclusion, Thomas said ureteroscopy can be considered first-line therapy for mid- or distal ureteral stones. However, the procedure shares a similar efficacy rate as extracorporeal shock wave lithotripsy for the treatment of renal calculi.
“There is a need for direct comparison in the literature of all modalities treating paediatric stone disease to facilitate guidelines that help treating surgeons choose the most efficacious modality offering the highest success rates with the lowest morbidity,” he added.
Source: J. Thomas, et al., "How effective is ureteroscopy in the treatment of paediatric stone disease?," Journal Urological Research; DOI 10.1007/s00240-010-0293-2
