Efficacy and safety of semirigid ureterolithotripsy in pediatric urolithiasis: Retrospective analysis from a tertiary center

BACKGROUND Endoscopic ureterolithotripsy (EUL) is a minimally invasive and effective treatment for pediatric ureteral stones, offering high success rates while addressing anatomical challenges unique to children. AIM To evaluate the success and safety of EUL in pediatric patients, focusing on lithotripsy technique, stone location, and patient-specific variables. METHODS A retrospective analysis was performed on 250 children treated with EUL from 2015 to 2022. Laser and pneumatic lithotripsy techniques were compared in terms of stone-free rate (SFR), operative duration, and complication rates. Outcomes were also analyzed by stone location and patient age. RESULTS The overall SFR was 92.1%, with rates of 94% for distal, 89% for mid-ureteral, and 91% for proximal stones (P = 0.07). Laser lithotripsy showed a slightly higher success rate than pneumatic lithotripsy (P = 0.08) and slightly shorter operative times (P = 0.1). The mean procedure duration was 42.8 ± 16.3 minutes and was longer for proximal stones (P = 0.04). The overall complication rate was 12.4%, with the highest incidence among children aged 4-7 years (P = 0.02). Average hospital stay was 2.3 ± 0.5 days, with no significant intergroup differences. CONCLUSION EUL is a safe and effective treatment for pediatric ureterolithiasis. Laser lithotripsy offers a slightly procedural time advantage, while younger patients are more prone to intraoperative challenges. These findings support EUL as a first-line treatment, with careful planning needed for younger children.

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