Effectiveness of 4.5 F semirigid ureteroscope (Mini-URS) in the management of ureteral stones in children younger than 3 years of age

Abstract

Objective: We investigated the effectiveness of ureteroscopy (URS) performed with the smallest caliber (4.5 F) semirigid ureteroscope in children younger than 3 years. Materials and methods: URS was performed with a 4.5 F semirigid ureteroscope (Mini-URS). The operative outcomes of 16 children [7 females, 9 males; mean age 30.5 months (range 10-36 months)] who underwent URS in our clinics were evaluated retrospectively. Results: The mean stone diameter was 5.1 mm (range 3-15 mm). A Holmium: YAG laser lithotripter was used. Double J stents were inserted in 3 patients, while ureteral catheterization was performed in 6. In 7 patients, we were unable to insert a double J stent. At the end of the first postoperative week, 13 (84%) patients were completely stone-free. Double J stents were inserted in two patients because of poor endoscopic visualization and inadequate stone fragmentation. In these patients repeat URS was performed to retrieve residual stones during removal of the double J stents. After 1 month, 15 (93.75%) patients were stone-free. No perioperative or early postoperative complication was observed in any patient. Conclusion: URS performed with a 4.5 F semirigid ureteroscope is an ideal alternative for retrieving ureteral stones, with lower complication rates, faster ureteral engagement, and shorter operating times, even in very young patients.