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• W1992804567 abstract "No AccessJournal of UrologyStones/Ureteroceles1 Sep 2000TREATMENT OF DISTAL URETERAL STONES IN CHILDREN: SIMILARITIES TO THE AMERICAN UROLOGICAL ASSOCIATION GUIDELINES IN ADULTS John G. Van Savage, Lucio G. Palanca, Robert D. Andersen, Ganesh S. Rao, and Bruce L. Slaughenhoupt John G. Van SavageJohn G. Van Savage More articles by this author , Lucio G. PalancaLucio G. Palanca More articles by this author , Robert D. AndersenRobert D. Andersen More articles by this author , Ganesh S. RaoGanesh S. Rao More articles by this author , and Bruce L. SlaughenhouptBruce L. Slaughenhoupt More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67259-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The American Urological Association (AUA) published clinical guidelines for the treatment of ureteral calculi in adults and note that up to 98% of stones less than 5 mm. in diameter will pass spontaneously. Ureteroscopy and shock wave lithotripsy were acceptable treatment choices for stones less than 10 mm. in diameter in the distal ureter. We reviewed our management of distal ureteral stones in children to see if the AUA Guidelines for adults would apply. Materials and Methods: A total of 14 males and 19 females with a mean age of 12 years (range 0.5 to 17) required hospitalization in the last 6 years for distal ureteral obstruction due to stones. Excretory urography or computerized tomography was performed in all cases, and mean stone size was 4 mm. (range 1 to 15). When stones did not pass spontaneously most patients were treated with ureteroscopic laser lithotripsy. Results: There were 12 (36%) with a mean age of 11 years and a mean stone size of 2 mm. (range 1 to 3) who passed stones spontaneously with intravenous hydration and narcotics. No child passed a stone 4 mm. or greater spontaneously in this series. Of 21 patients (64%) with a mean age of 12 years and a mean stone size of 5 mm. (range 1 to 15) 2 were treated with ureteral stents, 17 with ureteroscopic lithotripsy and 2 with shock wave lithotripsy. All patients were stone-free at the end of the procedures. The stone composition was predominantly calcium oxalate. Mean followup was 2 years. Conclusions: Similar to the AUA guidelines in adults, most stones less than 3 mm. in diameter in the distal ureter of children will pass spontaneously. Stones 4 mm or greater in the distal ureter are likely to require endosurgical treatment. Ureteroscopy and shock wave lithrotripsy have a high success rate for stones between 4 and 15 mm. in the distal ureter. Needle ureteroscope and laser lithotripsy have allowed more stones to be treated safely and effectively in smaller children. References 1 : Pediatric urolithiasis: medical and surgical management. Urology1996; 47: 292. Google Scholar 2 : Pediatric urolithiasis. Urol Clin North Am1997; 24: 173. Crossref, Medline, Google Scholar 3 : Treatment of pediatric urolithiasis between 1984 and 1994. J Urol1996; 156: 702. Link, Google Scholar 4 : Ureteral Stones Clinical Guidelines Panel summary report on the management of ureteral calculi. The American Urological Association. J Urol1997; 158: 1915. Link, Google Scholar 5 : Pediatric urolithiasis in the 1970s. J Urol1980; 123: 237. Link, Google Scholar 6 : Pediatric ureteroscopy for ureteric calculi: a 4-year experience. 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Google Scholar From the Division of Pediatric Urology, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byPenido M, Srivastava T and Alon U (2012) Pediatric Primary Urolithiasis: 12-Year Experience at a Midwestern Children's HospitalJournal of Urology, VOL. 189, NO. 4, (1493-1497), Online publication date: 1-Apr-2013.Dogan H, Onal B, Satar N, Aygun C, Piskin M, Tanriverdi O, Gurocak S, Gunay L, Burgu B, Ozden E, Nazli O, Erdem E, Yucel S, Kefi A, Demirci D, Uluocak N, Aridogan I, Turunc T, Yalcin V, Kilinc M, Horasanli K, Tan M, Soygur T, Sarikaya S, Kilicarslan H, Turna B, Doruk H and Tekgul S (2011) Factors Affecting Complication Rates of Ureteroscopic Lithotripsy in Children: Results of Multi-Institutional Retrospective Analysis by Pediatric Stone Disease Study Group of Turkish Pediatric Urology SocietyJournal of Urology, VOL. 186, NO. 3, (1035-1040), Online publication date: 1-Sep-2011.Kalorin C, Zabinski A, Okpareke I, White M and Kogan B (2009) Pediatric Urinary Stone Disease—Does Age Matter?Journal of Urology, VOL. 181, NO. 5, (2267-2271), Online publication date: 1-May-2009.Preminger G, Tiselius H, Assimos D, Alken P, Buck C, Gallucci M, Knoll T, Lingeman J, Nakada S, Pearle M, Sarica K, Türk C and Wolf J (2018) 2007 Guideline for the Management of Ureteral CalculiJournal of Urology, VOL. 178, NO. 6, (2418-2434), Online publication date: 1-Dec-2007.Singh A, Shah G, Young J, Sheridan M, Haas G and Upadhyay J (2018) Ureteral Access Sheath for the Management of Pediatric Renal and Ureteral Stones: A Single Center ExperienceJournal of Urology, VOL. 175, NO. 3, (1080-1082), Online publication date: 1-Mar-2006.STERNBERG K, GREENFIELD S, WILLIOT P and WAN J (2018) PEDIATRIC STONE DISEASE: AN EVOLVING EXPERIENCEJournal of Urology, VOL. 174, NO. 4 Part 2, (1711-1714), Online publication date: 1-Oct-2005.THOMAS J, DeMARCO R, DONOHOE J, ADAMS M, BROCK J and POPE J (2018) PEDIATRIC URETEROSCOPIC STONE MANAGEMENTJournal of Urology, VOL. 174, NO. 3, (1072-1074), Online publication date: 1-Sep-2005.MINEVICH E, DeFOOR W, REDDY P, NISHINAKA K, WACKSMAN J, SHELDON C and ERHARD M (2018) URETEROSCOPY IS SAFE AND EFFECTIVE IN PREPUBERTAL CHILDRENJournal of Urology, VOL. 174, NO. 1, (276-279), Online publication date: 1-Jul-2005.CASALE P, GRADY R, JOYNER B, ZELTSER I, KUO R and MITCHELL M (2018) TRANSPERITONEAL LAPAROSCOPIC PYELOLITHOTOMY AFTER FAILED PERCUTANEOUS ACCESS IN THE PEDIATRIC PATIENTJournal of Urology, VOL. 172, NO. 2, (680-683), Online publication date: 1-Aug-2004.MUSLUMANOGLU A, TEFEKLI A, SARILAR O, BINBAY M, ALTUNRENDE F and OZKUVANCI U (2018) Extracorporeal Shock Wave Lithotripsy as First Line Treatment Alternative for Urinary Tract Stones in Children: A Large Scale Retrospective AnalysisJournal of Urology, VOL. 170, NO. 6, (2405-2408), Online publication date: 1-Dec-2003.Schuster T, Russell K, Bloom D, Koo H and Faerber G (2018) Ureteroscopy For The Treatment Of Urolithiasis In ChildrenJournal of Urology, VOL. 167, NO. 4, (1813-1816), Online publication date: 1-Apr-2002.PIETROW P, POPE J, ADAMS M, SHYR Y and BROCK J (2018) CLINICAL OUTCOME OF PEDIATRIC STONE DISEASEJournal of Urology, VOL. 167, NO. 2 Part 1, (670-673), Online publication date: 1-Feb-2002. Volume 164Issue 3 Part 2September 2000Page: 1089-1093 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsureteroscopyureterchildlithotripsyurinary calculiMetricsAuthor Information John G. Van Savage More articles by this author Lucio G. Palanca More articles by this author Robert D. Andersen More articles by this author Ganesh S. Rao More articles by this author Bruce L. Slaughenhoupt More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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