Is flexible ureteroscopy and laser lithotripsy (FURLS) the new gold standard for paediatric lower pole stones: Outcomes from 2 large European tertiary paediatric endourology centres
BAUS ePoster online library. Brewin A. 06/23/21; 319051; p14-3
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Anna Elizabeth Brewin
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Abstract
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INTRODUCTION
Whilst paediatric Ureteroscopy is increasingly performed, the evidence for its use in lower pole stones (LPS) is sparse and management recommendations unclear. Our objective was to look at the effectiveness and outcomes of flexible ureteroscopy and lasertripsy (FURSL) in the management of LPS for the paediatric population.
METHODS
Data was collected retrospectively from two large European tertiary endourology centres specialising in paediatric kidney stone management. The inclusion criteria were patients in the paediatric age group (≤16 years) with LPS having a FURSL procedure. We collected patient demographic data, stones characteristics, surgical details and results with follow-up at 2-4 months post-surgery.
RESULTS
A total of 57 paediatric patients underwent FURSL for LPS. The mean age was 10.1 years + 4.7 (range: 1-16.9 years) with a male:female ratio of 2:3. The mean single stone size was 9.45+3.9 mm (range: 3-20 mm) and 31(54.4%) had multiple stones. A pre-operative stent was present in 18(31.6%) patients and a post-operative stent or ureteric catheter was left behind in 32(56.1%) patients.
The initial and final SFR was 82.4% and 98.2% respectively with 1.19 procedures per patient performed to be stone free. While there were no intra-operative complications, there were only four(7%) minor complications (Clavien I) noted which were all uncomplicated urinary infections. No other long-term complications were noted.
CONCLUSIONS
Flexible ureteroscopy and lasertripsy achieves excellent outcomes for treatment of paediatric LPS. While some patients might need a second procedure for complete stone clearance, this should be the new gold standard for treatment of LPS.
Whilst paediatric Ureteroscopy is increasingly performed, the evidence for its use in lower pole stones (LPS) is sparse and management recommendations unclear. Our objective was to look at the effectiveness and outcomes of flexible ureteroscopy and lasertripsy (FURSL) in the management of LPS for the paediatric population.
METHODS
Data was collected retrospectively from two large European tertiary endourology centres specialising in paediatric kidney stone management. The inclusion criteria were patients in the paediatric age group (≤16 years) with LPS having a FURSL procedure. We collected patient demographic data, stones characteristics, surgical details and results with follow-up at 2-4 months post-surgery.
RESULTS
A total of 57 paediatric patients underwent FURSL for LPS. The mean age was 10.1 years + 4.7 (range: 1-16.9 years) with a male:female ratio of 2:3. The mean single stone size was 9.45+3.9 mm (range: 3-20 mm) and 31(54.4%) had multiple stones. A pre-operative stent was present in 18(31.6%) patients and a post-operative stent or ureteric catheter was left behind in 32(56.1%) patients.
The initial and final SFR was 82.4% and 98.2% respectively with 1.19 procedures per patient performed to be stone free. While there were no intra-operative complications, there were only four(7%) minor complications (Clavien I) noted which were all uncomplicated urinary infections. No other long-term complications were noted.
CONCLUSIONS
Flexible ureteroscopy and lasertripsy achieves excellent outcomes for treatment of paediatric LPS. While some patients might need a second procedure for complete stone clearance, this should be the new gold standard for treatment of LPS.
INTRODUCTION
Whilst paediatric Ureteroscopy is increasingly performed, the evidence for its use in lower pole stones (LPS) is sparse and management recommendations unclear. Our objective was to look at the effectiveness and outcomes of flexible ureteroscopy and lasertripsy (FURSL) in the management of LPS for the paediatric population.
METHODS
Data was collected retrospectively from two large European tertiary endourology centres specialising in paediatric kidney stone management. The inclusion criteria were patients in the paediatric age group (≤16 years) with LPS having a FURSL procedure. We collected patient demographic data, stones characteristics, surgical details and results with follow-up at 2-4 months post-surgery.
RESULTS
A total of 57 paediatric patients underwent FURSL for LPS. The mean age was 10.1 years + 4.7 (range: 1-16.9 years) with a male:female ratio of 2:3. The mean single stone size was 9.45+3.9 mm (range: 3-20 mm) and 31(54.4%) had multiple stones. A pre-operative stent was present in 18(31.6%) patients and a post-operative stent or ureteric catheter was left behind in 32(56.1%) patients.
The initial and final SFR was 82.4% and 98.2% respectively with 1.19 procedures per patient performed to be stone free. While there were no intra-operative complications, there were only four(7%) minor complications (Clavien I) noted which were all uncomplicated urinary infections. No other long-term complications were noted.
CONCLUSIONS
Flexible ureteroscopy and lasertripsy achieves excellent outcomes for treatment of paediatric LPS. While some patients might need a second procedure for complete stone clearance, this should be the new gold standard for treatment of LPS.
Whilst paediatric Ureteroscopy is increasingly performed, the evidence for its use in lower pole stones (LPS) is sparse and management recommendations unclear. Our objective was to look at the effectiveness and outcomes of flexible ureteroscopy and lasertripsy (FURSL) in the management of LPS for the paediatric population.
METHODS
Data was collected retrospectively from two large European tertiary endourology centres specialising in paediatric kidney stone management. The inclusion criteria were patients in the paediatric age group (≤16 years) with LPS having a FURSL procedure. We collected patient demographic data, stones characteristics, surgical details and results with follow-up at 2-4 months post-surgery.
RESULTS
A total of 57 paediatric patients underwent FURSL for LPS. The mean age was 10.1 years + 4.7 (range: 1-16.9 years) with a male:female ratio of 2:3. The mean single stone size was 9.45+3.9 mm (range: 3-20 mm) and 31(54.4%) had multiple stones. A pre-operative stent was present in 18(31.6%) patients and a post-operative stent or ureteric catheter was left behind in 32(56.1%) patients.
The initial and final SFR was 82.4% and 98.2% respectively with 1.19 procedures per patient performed to be stone free. While there were no intra-operative complications, there were only four(7%) minor complications (Clavien I) noted which were all uncomplicated urinary infections. No other long-term complications were noted.
CONCLUSIONS
Flexible ureteroscopy and lasertripsy achieves excellent outcomes for treatment of paediatric LPS. While some patients might need a second procedure for complete stone clearance, this should be the new gold standard for treatment of LPS.
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