Effectiveness of Holmium Laser Therapy Together with 7Fr Ureterorenoscopy in Preschool Children

Purpose: We aimed to evaluate the success of semirigid (7 Fr) ureterorenoscope used in our clinic in the treatment of ureteral stone in pre-school children (0-6 years)
Materials and Methods: Between January 2012 and February 2018, 36 patients who underwent endoscopic ureteral stone treatment for ureteral stone in our clinic were retrospectively evaluated. During the procedure, 7 Fr semirigid ureterorenoscope and were used holmium: YAG laser as lithotripter. The evaluation of the stone-free rates of the patients was done visually during the fragmentation and 1 month later by the urinary ultrasonography.
Results: The mean age of the patients was 37.5 months. Of the patients, 55.6% were male and 44.4% were female. Stone localization was 58.3% distal ureter, 16.7% middle ureter and 25% proximal ureter. After the first ureterorenoscopy procedure stone-free rate was 58.3%. During the first ureterorenoscopy procedure, 38.9% patients were admitted with DJ stent, which could not reach intra-operative stones. After 1 month, 2nd session ureterorenoscopy was performed. During the first ureterorenoscopy procedure, ureteral perforation developed in 2.8% of the patients. Ureterolithotomy was performed with open surgery. After the first and second ureterorenoscopy procedures, the stone-free rate was 97.2%. In the early postoperative period, slight bleeding in 2 patients and high fever (> 38.5 °C) in 4 patients was observed. Mean hospital stay was 2.3 days.
Conclusion: Endoscopic ureteral stone treatment with 7 Fr ureterorenoscopy can be safely performed in preschool age group with high success and low complication rates even in very young children.