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Two‐year‐old girl with impacted ureteral stone successfully treated with a single session of combined percutaneous nephrostomy and ureteroscopy
Author(s) -
Sugino Teruaki,
Hamamoto Shuzo,
Unno Rei,
Moritoki Yoshinobu,
Hamakawa Takashi,
Naiki Taku,
Ando Ryosuke,
Okada Atsushi,
Yasui Takahiro
Publication year - 2017
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13319
Subject(s) - medicine , ureteroscopy , percutaneous nephrostomy , surgery , impaction , ureter , nephrostomy , hydronephrosis , percutaneous nephrolithotomy , percutaneous , urinary system
Impacted stones frequently cause changes in the ureter, including edema of the ureteral wall, stone embedding in the ureteral mucosa or ureteral bending, which often preclude spontaneous passing of the stone and increase the risk of complications during surgery. When stone impaction is suspected preoperatively, management should be adapted accordingly. However, surgical treatment strategies remain controversial in pediatric patients because of the scarcity of cases reported. We describe the case of a 2‐year‐old girl with a right impacted ureteral stone who presented with gross hematuria and pyuria, but no metabolic risk factors or hematological abnormalities. Ureteroscopy was carried out in the presence of a percutaneous nephrostomy catheter. At the 7‐month follow up, hydronephrosis had improved from grade 3 to grade 1, and the ureter was free from residual or recurrent stones. No complications were noted. We believe that percutaneous nephrostomy before the lithotripsy facilitates treatment for impacted stones in pediatric patients.