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Microureteroscopy in the treatment of upper urinary tract stones in pediatric patients younger than 3 years of age

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Abstract

The aim of this study is to evaluate the usefulness of microureteroscopy (m-URS) in the treatment of renal and ureteral stones in children younger than 3 years of age. A retrospective analysis of pediatric patients aged < 3 years with upper urinary tract calculi who underwent lithotripsy was performed. The children were divided into the m-URS group (4.85 F, n = 41) and the ureteroscopy (URS) group (4.5/6.5 F, n = 42) according to the type of ureteroscope used. The mean age of the patients was 23.5 ± 10.7 months in the m-URS group and 20.6 ± 7.1 months in the URS group (P = 0.212). The success rate of one-stage surgery was 80.5% (33/41) for m-URS and 38.1% (16/42) for URS (P < 0.001). The success rates of m-URS were 60.0%, 69.2%, and 91.3% for stones located in the renal pelvis/calix, upper ureter, and mid-lower ureter, respectively. Eight children in the m-URS group and 26 children in the URS group underwent the second-stage ureteroscopic surgery. The mean operation time was 50 (30–60) min in the m-URS group and 40 (34–60) min in the URS group (P = 0.287). The complication rates were 4.9% and 7.1% in the m-URS and URS groups, respectively (P = 1.000). The stone-free rate at 1 month after lithotripsy was 87.8% in the m-URS group and 83.3% in the URS group (P = 0.563). The mean anesthesia session was 2.1 in the m-URS group and 2.5 in the URS group (P = 0.002). M-URS can effectively reduce the number of anesthesia sessions and is considered an alternative treatment for upper urinary tract calculi in selected pediatric patients younger than 3 years of age.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

This work was supported by the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding (XMLX202101).

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  1. Ruichao Zhan and Yucheng Ge have contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Beijing Friendship Hospital, Capital Medical University, 95 YongAn Road, Xicheng District, Beijing, 100050, China

    Ruichao Zhan, Yucheng Ge, Yukun Liu, Zhenqiang Zhao, Jun Li & Wenying Wang

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  1. Ruichao Zhan
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  2. Yucheng Ge
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Contributions

RZ, YG, and WW helped with the study design and data collection. YL and ZZ helped with the statistical analysis and interpretation. RZ and YG wrote the main manuscript text. JL and ZZ prepared Figs. 1, 2 and Tables 1, 2, 3. All authors reviewed the manuscript. All the authors helped revise and draft the article.

Corresponding author

Correspondence to Wenying Wang.

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The authors declare that they have no conflicts of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki and approved by the Ethics Committee of Beijing Friendship Hospital, Capital Medical University (Date 02/01/2021/No. 2021-P2-019).

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Informed consent was obtained from all the participants included in the study.

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Zhan, R., Ge, Y., Liu, Y. et al. Microureteroscopy in the treatment of upper urinary tract stones in pediatric patients younger than 3 years of age. Urolithiasis 51, 64 (2023). https://doi.org/10.1007/s00240-023-01435-5

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