Abstract

Objective: With advancements in endourological equipment and the routine use of the Holmium:YAG laser, endoscopic treatment has become the first-line approach for managing ureteral stones in children. Although ureteroscopy is widely performed, the literature reports varying outcomes regarding its efficacy in pediatric cases. This study aimed to evaluate the impact of increasing endourological experience on stone-free rates and procedure-related complications in children undergoing ureteroscopy with Holmium: YAG laser for ureteral stones 

Material and Methods: A comparative analysis was conducted on 32 cases treated with URS for ureteral stones between 2009-2011, the initial three years of our endourological interventions in children, and 78 cases treated with URS for ureteral stones between 2020-2022, the final three years of our 15-year endourological experience, utilising hospital records as the primary data source. Demographic data, stone-free rates, and recorded complications were evaluated in both groups. 

Results: In our initial cohort of 32 cases, the stone-free rate at first attempt was 57%, with a complication rate of 15.6% and a conversion rate to open surgery of 18.75%. In contrast, during the last three years, 73 patients (93.5%) achieved stone-free status with a single URS session. Only one case (1.3%) required conversion to open surgery. Complications were observed in 10.2% of cases. Notably, the use of passive dilation with preoperative JJ stent placement became more prevalent during the latter period.

Conclusion: Increasing surgical experience is associated with higher stone-free rates following a single intervention. There were no significant differences in the overall or major complication rates between the two periods. Postoperative fever remains a common complication, underscoring the importance of careful management of JJ stent placement. The most notable parameter that showed a significant improvement with increased experience was the reduced rate of conversion to open surgery.

Keywords: Children, Complication, Ureteroscopy, Ureterolithiasis

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Copyright © 2025 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

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1.
Demirtaş G, Tagcı S, Ekberli G, Karabulut B, Tiryaki HT. Ureteroscopy for ureteral stones in children: what has changed with the increase in experience?. Turk J Pediatr Dis [Internet]. 2025 Jul. 2 [cited 2025 Jul. 7];:1-5. Available from: https://turkjpediatrdis.org/article/view/1112