Interest of URS-L in the Treatment of Ureterolithiasis in Preschool Children

Halinski, Adam; Zaniew, Marcin; Kudliński, Bartosz; Sołtysiak, Jolanta; Sobolewski, B.; Steyaert, Henri

doi:10.3389/fped.2019.00324

Cited by 10 publications

(5 citation statements)

References 22 publications

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“…In the case of lack of consent, failure or contraindications for the ESWL procedure, two endoscopic alternatives can be proposed: transurethral RIRS or percutaneous PCNL. Due to the progressing miniaturization of the equipment, the diameter of the instruments in both cases enables intervention in increasingly younger pediatric patients (8). In our practice, the youngest patient who successfully underwent the RIRS procedure was a 8 month-old girl with bilateral kidney stone disease.…”

Section: Introductionmentioning

confidence: 97%

Endourology Methods in Pediatric Population for Kidney Stones Located in Lower Calyx: FlexURS vs. Micro PCNL (MicroPERC®)

et al. 2021

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Kidney stone disease in children is always a therapeutic challenge. It is a multifactorial condition and it should be approached, diagnosed and treated as such. One of the biggest challenges is kidney stones located in the lower renal calyx. There are currently three main surgical techniques to treat this condition: ESWL—Extracorporeal Shock Wave Lithotripsy, RIRS—Retrograde IntraRenal Surgery, and PCNL—PerCutaneous Nephro-Lithotripsy. In pediatric population, the most frequently used method is ESWL, and in the event of failure, endoscopic procedures are the second-best choice. In this article, a sample of 53 children admitted to a tertiary medical center was examined. Thirty-eight of those children underwent flexible URS, while the remaining 15—micro PCNL. The average size of the deposit in the former group was 12.2 mm, against 13.5 mm in the latter. The full Stone Free Rate (SFR) was achieved in RIRS at 84.21 and 86.7% in percutaneous nephrolithotripsy. Flexible ureterorenoscopy and MicroPERC are two comparably effective methods for treating lower calyx stones of any size. However, according to our data, flexible ureterorenoscopy carries a lower risk of complications and inpatient care (with the mean of 3 days). The learning curve for these procedures in pediatric urology is long and relies on a limited number of patients. The number of pediatric patients qualifying for these procedures is restricted also due to the high efficacy of extracorporeal shock wave lithotripsy in pediatric population. Radiation exposure is an important factor in every endoscopy procedure and should never exceed the limits set in the ALARA protocol. ESWL remains to this day the treatment of choice for stone disease in children and can be performed under ultrasound control. For many parents, it is a first-choice treatment preference for their child due to its greater apparent safety, although data on this remains insufficient. Prospective, randomized, multicenter trials are definitely needed.

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Section: Introductionmentioning

confidence: 97%

Endourology Methods in Pediatric Population for Kidney Stones Located in Lower Calyx: FlexURS vs. Micro PCNL (MicroPERC®)

et al. 2021

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“…Over the past 50 years, the prevalence of urinary calculi continued to increase, both in adults and pediatric population (46). The increase was initially observed in Western countries, but in more recent years the prevalence of kidney stones also tended to increase in many other countries around the world.…”

Section: Introductionmentioning

confidence: 99%

Kidney Stone Composition in Various Country Around the World

Halinski

Popov

Bhattikam

et al. 2021

Preprint

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To compare urinary stone composition patterns in different populations around the world in relation to the structure of their population, dietary habits, and climate. 1204 adult patients with urolithiasis and stone analysis was included . International websites were searched to obtain data. We observed 710(59%) patients with calcium oxalate, 31(1%) calcium phosphate, 161(13%) mixed calcium oxalate/calcium phosphate, 15(1%) carbapatite, 110(9%) uric acid, 7(<1%) urate, 100(9%) mixed uric acid/ calcium oxalate, 56(5%) struvite and 14(1%) cystine stones. Calcium stones were the most common in all countries (up to 91%) with the highest rates in Canada and China. Oxalate stones were more common than phosphate or mixed phosphate/oxalate stones except Egypt and India. The rate of uric acid stones, being higher in Egypt, India, Pakistan, Iraq, Poland, and Bulgaria. Struvite stones occurred in less than 5% except India (23%) and Pakistan (16%). Cystine stones occurred in 1%. The frequency of different types of urinary stones varies from country to country. Calcium stones are prevalent in all countries. Uric acid stones seems to depend mainly on climatic factors, being higher in countries with desert or tropical climates. Dietary patterns can also lead to an increase it. Struvite stones are decreasing in most countries.

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“…Other series and systematic reviews have also commonly commented on CD complication of ⩽ 3 for paediatric URSL. 12 – 17 …”

Section: Discussionmentioning

confidence: 99%

“…Other series and systematic reviews have also commonly commented on CD complication of ⩽ 3 for paediatric URSL. [12][13][14][15][16][17] The European Association of Urology (EAU) urolithiasis guidelines 18 includes all the three modalities (SWL, URS and PCNL) for active intervention of renal stone disease, with SWL and fURS offering a SFR of 70-90% and 76-100%, respectively. SWL is the first choice of treatment for paediatric stone disease though it often requires sedation or general anaesthetic in this population for patient positioning and tolerability of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of ureteroscopy for management of stone disease in early and late childhood over a 15-year period

Mani

Pietropaolo

Madarriaga

et al. 2022

Therapeutic Advances in Urology

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Background: Although paediatric ureteroscopy is widely performed, there is still a lack of data and outcomes in early childhood. In this two-centre study, we compared the outcomes of ureteroscopy for stone disease management in early and late childhood and provide outcomes for the same. Methods: Data was retrospectively collected on consecutive patients from two tertiary paediatric endo-urology European centres over a 15-year period (2006–2021). Patients were split into two groups, namely, early childhood (age ⩽ 9 years) and late childhood (age 9 to ⩽16 years). Outcomes including stone-free rate (SFR) and complications were compared between these two groups. Results: A total of 148 patients underwent 184 procedures (1.2 procedure/patient) during the study period (66 in early childhood and 82 in late childhood). The mean age in early and late childhood groups were 5.6 and 13.3 years, and a male: female ratio of 1.6:1 and 1.1:1, respectively. The SFR and complications in early and late childhood groups were 87.8% and 90.2% ( p = 0.64) and 5.7% and 4.1%, respectively. Conclusion: Paediatric ureteroscopy and laser stone fragmentation achieves good results in both early and late childhood with comparable SFRs, although the complications and need for second procedure were marginally higher in the early childhood group. Our study would set up a new benchmark for patient counselling in future, and perhaps this needs to be reflected in the paediatric urolithiasis guidelines.

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Interest of URS-L in the Treatment of Ureterolithiasis in Preschool Children

Cited by 10 publications

References 22 publications

Endourology Methods in Pediatric Population for Kidney Stones Located in Lower Calyx: FlexURS vs. Micro PCNL (MicroPERC®)

Endourology Methods in Pediatric Population for Kidney Stones Located in Lower Calyx: FlexURS vs. Micro PCNL (MicroPERC®)

Kidney Stone Composition in Various Country Around the World

Outcomes of ureteroscopy for management of stone disease in early and late childhood over a 15-year period

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