Microureteroscopy in Children: Two First Cases

Abstract

Background: Urinary stones disease is becoming more common not only in adults but also in children. Most cases are resolved with extracorporeal shock wave lithotripsy, but miniaturization of endoscopes has increased the use of ureteroscopy in resolving ureteral stones, most notably in children.Case Presentation: This presentation focuses on two cases of microureteroscopy. In both cases, the presence of lithiasis in the pelvic ureter was suspected to be the cause of ureter hydronephrosis, and a microureteroscopy was performed for treatment purposes. MicroPerc set 4.85F sheath was used to explore the pelvic ureter, thus avoiding the need to dilate the ureteral meatus or having to use the safety guide. Patients did not require a postoperative stent and were discharged within 24 hours of the procedure.Conclusion: Use of microureteroscopy proved satisfactory in the two cases of children and it allows diagnosis and treatment of ureteral pathology in pediatric patients.

Micro-Ureteroscopy as a Treatment of Renal Pelvis Lithiasis in Young Children

“…Furthermore, in our case, the minimum requirement of auxiliary procedures (transient nephrostomy or JJ ureteral stenting) reduced the total cost of the procedure. We think that we will also have less associated morbidity (2,6).…”

“…Irrigation with saline solution and a 0.9 mm flexible fiber optic connected to the telescope are added to the other 2 connections for an adequate view, transmitting the image from the tip of the sheath. Some authors used the "microperc" access in a limited number of children for the treatment of lithiasis or recurrent peiloureteral stenosis, demonstrating that this technique can also be considered safe in preschool children (3,(5)(6)(7)(8)(9). However, there is no evidence of its efficacy in larger series of patients.…”

“…Some urologists publications describe the treatment of pelvic distal ureteral lithiasis in women by retrograde microureteroscopy, with 4.85 Fr sheath used by micropercutaneous approach. Subsequently, some cases of ureteral lithiasis in young children have been reported using the 4.8 Fr sheath as a ureteroscope ( 6 ).…”