Syed Saeed Abidi, Irfan Feroz, Owais Khawar, Saquib U Khan, Mohammad Aslam, Hamid Ali.
Pediatric Urethro-Cystolitholapaxy: Application of adults ureterorenoscope for the management of pediatric impacted urethral and vesical stones.
Pak J Surg Jan ;33(1):30-5.

Objective: In the scenario where our forty four million population is in pediatric age group, and endoscopic instruments designed for children are not commonly available, we conduct this study to highlight the possibility of effective use of adult size Ureterorenoscope and Pneumatic Lithoclast in pediatric population having urethral and vesical stones. Study design: Experimental clinical practice study Study duration: Eighteen months Methods: In this study we managed fifty cases of pediatric lower tract urinary stones in a government hospital. Children having up to two centimeters urethral or vesical stones were included in this study. All cases were treated endoscopically via adult size Ureterorenoscope and Pneumatic Lithoclast. Pre-decided safety and efficacy parameters were recorded and discussed. SPSS version 17 was used for Statistical analysis. Fisher exact test and student’s t-test were done for categorical and continuous variables respectively. Modified Clavien classification was used for complication assessment. Results: Of the 50 children’s, 21(42%) had impacted urethral and 29(58%) had vesical stones. Age range was 8 to 72 months. Average procedure duration was 40 minutes. All cases were completed successfully and no operative trauma was reported. Stone clearance after first surgery was 98 percent. Average duration of post-operative indwelling urethral catheter was 18 hours. Twelve percent patients had mild hematuria. All except one was discharged within 24 hours of surgery without urethral catheter. Conclusion: In careful hands adult Ureterorenoscope with Pneumatic Lithoclast can be effectively used in pediatric population. Its efficacy and safety matches the procedure outcome as in both adult and pediatric group where specialized appropriate size instruments were used.

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