Endoscopic management of pediatric urolithiasis in a developing country
Received 19 May 2003; accepted 8 August 2003.
Abstract
Objectives
To evaluate our experience with the endoscopic management of lower and upper urinary tract stones in pediatric patients in the Republic of Yemen.
Methods
From January 1, 1993 to December 31, 1998, 290 endoscopic operations were performed on 265 pediatric patients up to 14 years of age, 173 on the upper and 117 on the lower urinary tract. Of these procedures, 138 were percutaneous nephrolithotomy, 5 were endopyelotomy combined with percutaneous nephrolithotomy, 30 were ureteral lithotripsy, and 117 were percutaneous cystolithotomy. Of the 265 patients, 244 were boys and 21 girls (male/female ratio 11.6:1, upper tract 7.4:1, lower tract 116:1) aged 8 months to 14 years (mean age 7.1 years). The 26F adult nephroscope and 9.5F semirigid ureteroscope were used.
Results
The overall success rate was 98.9%. Minor complications were observed in 29 patients (10.7%); severe complication did not occur. The nucleus and/or the main component of the stones was ammonium urate in 73.5% of the cases (upper tract 54%, but for those younger than 5 years, it was 75%; lower tract 93%).
Conclusions
The endoscopic management of pediatric urolithiasis is a safe and effective method. To our knowledge, this is the largest reported series on the endoscopic management of pediatric urolithiasis.
aDepartment of Urology, Semmelweis Hospital, Kiskunhalas, Hungary
bDepartment of Urology, Millat Hospital, Sadikabad, Pakistan
cDepartment of Urology, University of Debrecen Medical and Health Science Center, Debrecen, Hungary
Reprint requests: Morshed A. Salah, M.D., Ph.D., Department of Urology, University of Debrecen Medical and Health Science Center, Nagyerdei krt. 98, Debrecen 4032, Hungary
ABSTRACT