Paediatric stone disease is rare in the Nordic communities. Still, the condition can require surgical intervention in the form of ureteroscopy (URS). Here, we report outcomes achieved at a regional (tertiary) centre.
Retrospective analysis was performed of consecutive patients (<18 years of age) undergoing URS for stone disease between 2010 and 2021. Outcomes of interest included stone-free rate (SFR) determined using a definition of no residual fragments ⩾ 3 mm on imaging and complications classified according to Clavien-Dindo system.
In total, 23 patients underwent 47 URS procedures for a total of 31 stone episodes. Mean age was 9 (range 1-17) years and male-to-female ratio was 6:17. Overall, 35% had at least one medical comorbidity. Ultrasound determined preoperative stone status in 87%. Mean largest index and cumulative stone sizes were 9 (range 3-40) and 12 (range 3-40) mm, respectively. Overall, 32% had multiple stones. Lower pole was the commonest stone location (39%). No patients underwent elective pre-operative stenting. Ureteral access sheaths were not used in any cases. Access to upper urinary tract at first procedure was successful in 94%. Initial and final SFR was 61% and 90%, respectively. No intra-operative complications were recorded. Overall post-operative complication rate was 17.5%. Urinary tract infection (CD II) was the commonest adverse event (12.5%).
Paediatric URS can be delivered in the setting of a regional centre without compromising outcomes. This includes when carried out by adult endourologists, without routine pre-stenting and omitting use of ureteric access sheath.
Therapeutic advances in urology. 2022 Aug 22*** epublish ***
Patrick Juliebø-Jones, Mathias Sørstrand Æsøy, Peder Gjengstø, Christian Beisland, Øyvind Ulvik
Department of Urology, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway., Department of Urology, Haukeland University Hospital, Bergen, Norway., Department of Urology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway., Haukeland University Hospital, Bergen, Norway.