ENDOSCOPIC TREATMENT OF PEDIATRIC UROLITHIASIS

Children have been slow to benefit from the improvements in stone ther apy. Despite the success of less invasive techniques, open surgery for pediatric urolithiasis is still commonly practiced. The authors' goal was to evaluate the indications, efficacy, add complications of endou rologic surgery in the treatment of pediatric urolithiasis. they revie wed the treatment of 53 children who had upper tract calculi. Open nep hro- and ureterolithotomy were avoided in all cases. The management of 25 children whose stones were not amenable to extracorporeal shock wa ve lithotriopsy is presented. Seventeen children (19 stones) were trea ted with miniature ureteroscopes and lasertripsy. Only one (6%) of the patients required ureteral dilation. and only five (29%) needed a pos toperative internal Stent. Eight children with large renal calculi wer e treated percutaneously. without transfusion. complication. or eviden ce of persistent renal damage. All 25 patients ware rendered stone-fre e. The hospital stay was shorter and secondary procedures were less co mmon in comparison to other series of endoscopic lithotripsy. With sig nificant experience in adult endourology and proper instrumentation, o ne can apply the same techniques to children and achieve equal if not greater benefit. Nephrolithiasis id children is uncommon and should be managed in an institution where endourologists and multiple treatment modalities are available. Copyright (C) 1996 by W.B. Saunders Company