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Ureteral stone in pediatric and treatment with lithotripsy

Background and Objective: Transureteral lithotripsy is an effective procedure in lower ureteral stone. This study was done to evaluate lithotripsy method in pediatric ureteral stones in Mashhadʹs Imam-Reza hospital. Patients and Methods: In our institue 38 patients went under ureteroscopy and lithotripsy for ureteral stones. Mean age in our patients was 6.8 years (range 2-13 years). 16 patients were male and 22 patients were female. The mean stone size was 7 mm (range 6-16 mm). Ultrasonography and KUB or IVP was performed in all cases. After general anesthesia and cystoscopy guide wire introducted in ureter, ureteroscopy were performed for lithotripsy used ultrasound pneumatic or electrohydroulic. Results: Stone were located in the distal ureter in 32 patients, in the midureter in 4 and in the proximal ureter in 2 cases. Ureteroscopy was successfully in 35 cases. Lithotripsy was used: ultrasound, electrohydrolic or pneumatic. We were unable to introduce the ureteroscope into the ureter in three patiens. In three patients stone migrated to the kidney after ureteroscopy. Then, they candidated for ESWL. Stone free was done in 32 cases (85%). A complication was 25% and treated with medical treatment. Conclusion: Our investigation demonstrates the high success rate ureteroscopy in pediatric group especially with a small caliber ureteroscope. Ureteroscopy should be considered the first choice for treatments of calculi in the distal ureter in children.