Category: Clinical Stones: Pediatrics

MP9-3 - Outcomes of ureteroscopy and stone treatment in young children (≤ 7 years): A systematic review

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective :

Ureteroscopy is an established treatment for renal and ureteric stones however its role in young children is still uncertain. We conducted a systematic review to look at the outcomes of ureteroscopy on paediatric patients under the age of 7.


Methods :

A systematic review carried out in a Cochrane style and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist using Medline, Scopus, CINAHL, EMBASE and Cochrane library for all English language articles on ureteroscopy, where the mean age of the patients was


Results :

A total of 12 studies were identified (814 patients) with a mean age of 4.7 years. The mean stone size was 10.4mm (range 3-30mm). The mean stone free rate was 89.7% (range 76.6-100%). Mean complication rate was 28.1%. An increased risk of minor complications was seen under 3 years of age, however, the data was heterogenous and so statistical analysis could not be performed. The most frequently occurring complications were haematuria (n= 64, 8%), fever (n= 58, 7%) and ureteric injury, including laceration and perforation (n= 34, 4%). Stone location was predominantly ureteric (n= 438), with the majority located in the distal ureter (n=270), than renal (n= 205). Twenty-five patients had renal and ureteric stones (n=9) or were listed as ‘other’ (n=16).


Conclusions :

While ureteroscopy for stone disease in young children achieves a good stone free rate, the risk of minor complications appears to be higher than those reported in the adult literature.

Patrick Jones

Resident
University Hospital Southampton
Southampton, England, United Kingdom

Adele L Barr

Clinical Fellow
Royal Hampshire County Hospital
Southampton, England, United Kingdom

Dr Adele Barr BMBS, Clinical Fellow, Royal Hampshire County Hospital

Omar Aboumarzouk

Urology Consultant
Glasgow Urological Research Unit, Department of Urology, Queen Elizabeth University Hospital, Glasgow, UK
Glasgow, Scotland, United Kingdom

Bhaskar K. Somani

Consultant Urologist, Associate Professor
University Hospital Southampton , U.K
Southampton, England, United Kingdom

Bhaskar is an Endourologist and Associate Professor in Southampton, and is an active member of European School of Urology 'Training and Research group' and ESUT Endourology group. He has been teaching on EUREP hands-on-training for the last 5 years and is the senior author in the new ‘Endoscopic stone treatment (EST)’ curriculum established for training and examinations. He has performed live surgery in EAU with presentations and moderations in EULIS, WCE and SIU. He is also a member of EAU ‘Train the Trainer’ committee.

He is research active and has published more than 200 papers with over 300 published abstracts/presentations. He is on the editorial board of 3 journals, a reviewer for 14 journals and Investigator for 5 trials. He sits on the MCQ panel for FRCS examinations and is a ‘Specialist advisor’ to National Institute of Clinical Excellence (NICE) Interventional procedures and ‘Invited expert’ to NICE urological infections. He is an elected member of BAUS Academic section and was recently selected as a Fellow of Faculty of Surgical Trainers.