Flexible Ureteroscopy for Upper Ureteral Calculi in Children

Introduction: Ureteroscopy is one of the therapeutic options in the management of urinary stone disease in children. Previous literature has described ureteroscopy primarily in mid to distal ureteral calculi. We report our experience with flexible ureteroscopy in the management of upper ureteral calculi. Patients and Methods: All children with upper ureteral stones were included prospectively in the study. Stone burden was measured in millimeters. Presentation, operative access, intraoperative complications, stone-free rates, and postoperative complications were evaluated. Results: A total of 80 children (69 boys and 11 girls) underwent 88 ureteroscopic procedures. In 72 (90%) children, complete stone clearance was achieved after a single ureteroscopic session. In 6 (7.5%) others, complete stone clearance was achieved after the second ureteroscopic session. Conclusions: Complete stone clearance after single ureteroscopy is possible if the calculi are single, small (< 10 mm), and below the level of the pelviureteral junction.