Korean J Urol.  2010 Jan;51(1):73-75.

Ureteroscopic Surgery for a Large Upper Ureteral Stone in an Infant with Bilateral Vesicoureteral Reflux

• Baek M
• Paick SH
• Lee BK
• Kang MB
• Lho YS
• Kim KS
• Kim HG

Abstract

Pediatric urolithiasis is a relatively rare disease that can have lifelong consequences. The management of pediatric urolithiasis should be individualized with careful consideration of the patients' small body sizes, delicate tissues, needs for general anesthesia with every procedure, and risks of long-term complications. Miniaturization of urological instruments has made the treatment of distal ureteral stones by ureteroscopy in children more common, but there are few reports of the ureteroscopic removal of large upper ureteral stones in infants. We present a case of a 10-month-old female who simultaneously underwent ureteroscopic surgery and endoscopic Deflux(R) injection for treatment of a 22x10 mm unilateral upper ureteral stone and bilateral vesicoureteral reflux. We also review the current treatment options for pediatric urolithiasis.

Keyword

Urolithiasis; Infant; Ureteroscopy; Vesico-ureteral reflux

MeSH Terms

Anesthesia, General
Body Size
Child
Female
Humans
Infant
Miniaturization
Rare Diseases
Ureter
Ureteroscopy
Urolithiasis
Vesico-Ureteral Reflux

Figure

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  FIG. 1 (A) Voiding cystourethrography showing a 22×10 mm right ureteral stone at the L4-5 level. Right reflux was interrupted by the ureteral stone. (B) Ultrasonography revealing a moderate degree of hydronephroureterosis containing turbid urine. (C) The stone was very large, inducing complete obstruction of the ureteral lumen.

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  FIG. 2 (A) Postoperative kidney-ureter-bladder (KUB) showing that the stone was completely removed. (B) Antegrade pyelography performed 2 days after surgery showing a passage disturbance of the right urinary tract with a narrowing of the right distal ureter. (C) Ultrasonography performed at 2 months after surgery showing no hydronephrosis on the right kidney.

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