Hasan Rıza AYDIN, İsa ÖZBEY, Yılmaz AKSOY, Turgut YAPANOĞLU

Ureteroscopic management of distal ureteral stones in children: holmium: YAG laser vs. pneumatic lithotripsy

Aim: In this retrospective study, we aimed to compare the treatment results of pneumatic and holmium laser-assisted ureteroscopy in managing distal ureteral calculi in children. Materials and methods: The study group included a total of 36 children (23 boys, 13 girls) who underwent ureteroscopy between June 1998 and April 2008 due to distal ureteral calculi. Pneumatic lithotripsy was performed in 11 children and holmium:YAG laser lithotripsy in 25. Results: Their ages ranged from 18 months to 14 years (mean: 8.5 ± 3.5 years). The overall success rate for the holmium:YAG laser lithotripsy (100%) was higher than that of pneumatic lithotripsy (81.8%), but the difference was insignificant (P = 0.087). The complication rate was higher in pneumatic lithotripsy than in holmium:YAG laser lithotripsy (36.4% versus 4%, P = 0.023). Treatment time and hospital stay were shorter in the holmium:YAG laser lithotripsy group than in the pneumatic lithotripsy group (32.4 min versus 42.3 min, P = 0.041; 17.4 h versus 33.6 h, P = 0.013, respectively). Conclusion: This study showed that the success rate for holmium:YAG laser lithotripsy was almost identical with that achieved by pneumatic lithotripsy in the treatment of distal ureteral stones; ureteroscopic holmium:YAG laser lithotripsy had significant clinical advantages over pneumatic lithotripsy in terms of operative time, and hospitalization duration, stent requirements, and complication rates.

Anahtar Kelimeler:

Key words: Laser, lithotripsy, pediatric ureteroscopy, ureteric calculi

Ureteroscopic management of distal ureteral stones in children: holmium: YAG laser vs. pneumatic lithotripsy

Keywords:

Key words: Laser, lithotripsy, pediatric ureteroscopy, ureteric calculi,

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Van Savage JG, Palanca LG, Andersen RD, Rao GS, Slaughenhoupt BL. Treatment of distal ureteral stones in children: similarities to the American urological association guidelines in adults. J Urol 2000; 164: 1089-1093.
Zeng GQ, Zhong WD, Cai YB, Dai QS, Hu JB, Wei HA. Extracorporeal shock-wave versus pneumatic ureteroscopic lithotripsy in treatment of lower ureteral calculi. Asian J Androl 2002; 4: 303-305. 8. Reddy PP, Barrieras DJ, Bägli DJ, McLorie GA, Khoury AE, Merguerian PA. Initial experience with endoscopic holmium laser lithotripsy for pediatric urolithiasis. J Urol 1999; 162: 1714- 1716.
Koura AC, Ravish IR, Amarkhed S, Nerli RB, Reddy M. Ureteroscopic stone management in prepubertal children. Pediatr Surg Int 2007; 23: 1123-1126.
Schuster TG, Russell KY, Bloom DA, Koo HP, Faerber GJ. Ureteroscopy for the treatment of urolithiasis in children. J Urol 2002; 167: 1813-1816.
El-Assmy A, Hafez AT, Eraky I, El-Nahas AR, El-Kappany HA. Safety and outcome of rigid ureteroscopy for management of ureteral calculi in children. J Endourol 2006; 20: 252-255.
Dogan HS, Tekgul S, Akdogan B, Keskin MS, Sahin A. Use of the holmium:YAG laser for ureterolithotripsy in children. BJU Int 2004; 94: 131-133.
Bapat SS, Pai KV, Purnapatre SS, Yadav PB, Padye AS. Comparison of holmium laser and pneumatic lithotripsy in managing upper-ureteral stones. J Endourol 2007; 21: 1425- 1427.
Jeon SS, Hyun JH, Lee KS. A comparison of holmium:YAG laser with lithoclast lithotripsy in ureteral calculi fragmentation. Int J Urol 2005; 12: 544-7. 15. Shroff
S, Watson GM. Experience with ureteroscopy in children.
Br J Urol 1995; 75:395-400.
Tan AHH, Al-Omar M, Denstedt JD, Razvi H. Ureteroscopy for pediatric urolithiasis: an evolving first-line therapy. Urology 2005; 65: 153-156.
Thomas R, Ortenberg J, Lee BR, Harmon EP. Safety and efficacy of pediatric ureteroscopy for management of calculous disease. J Urol 1993; 149: 1082-1084.
Sofer M, Binyamini J, Ekstein PM, Bar-Yosef Y, Chen J, Matzkin H et al. Holmium laser ureteroscopic treatment of various pathologic features in pediatrics. Urology 2007; 69: 566-569.