Factors affecting the outcome of ureteroscopy in the management of ureteral stones in children.

Purpose: To identify the factors involved in failure and post-operative complications of retrograde rigid ureteroscopy (URS) in the treatment of ureteric stones in children.

Methods: This is a retrospective study, including 33 children who underwent 34 rigid URS (one case bilateral) for obstructive ureteric stones over a period of 10 years. Patient age, sex, presenting symptoms, stone size and location, operative technique, surgical outcomes and complications were recorded. Ureteroscopy was done in a manner similar to that in adults. Statistical analysis was performed using the Mann-Whitney U, the Chi-square or Fisher's exact test.

Results: There were 33 children (22 girls and 11 boys) with a mean age of 10.8 years (range 4-16 years) presenting 34 stones. The site of stones was pelvic in 24 cases (70.5%), iliac in 2 cases (6%) and lumbar in 8 cases (23.5%). The mean size of stones was 10.9 mm (5-22 mm). The success rate was 91%. There were no intraoperative complications. Post-operative complications rate was 21%. Factors associated with failure were size, localization of the stone, and delay of surgery. Factors associated with post-operative complications were size of the stone and operative time.

Conclusion: The rigid URS in children is a reliable and effective treatment option in the management of ureteric stones. Favorable factors for success of the procedure are pelvic stone and stone size <10 mm.