Proximal ureteral access for symptomatic stone removal using ultrathin semirigid ureterorenoscope in preschool-age children: Is it possible?

Introduction and Objectives We aimed to point out the ureteral access facility and obstruction removal efficiency of mini-URS in the use of proximal ureteral stone management in children under five-year-old. Patients We retrospectively reviewed the data of 26 children who underwent mini-URS-LL for obstructive stones in proximal ureter between January 2016 and August 2018. The effectiveness of the mini-URS-LL was assessed based on the feasibility, reliability, and success of the technique. Results Mean age was 3 ± 1.3 years, and 11 (42.3%) patients were ≤2 years old, remaining 15 (57.7%) were aged 3−5 years. Mean stone size was 9.11 ± 3.02 mm. A stone-free status was obtained at the end of 31 ureteroscopic procedure in 24 (92.3%) patients. The mean age was found significantly higher in patients who had the procedure without pre-stenting than the others who did (P = .027). No perioperative complication was experienced. Conclusion In preschool-age children, laser lithotripsy with mini-URS may be a safe technique in the hands with advanced endo-urological skills but it has low efficacy with higher rates of prestenting causing additional anesthesia sessions.