[P-093]

Çocuk hastalarda üreteroskopi sonuçlarımız: Tek merkez deneyimi

Rahmi Gökhan Ekin, Yusuf Özlem İlbey, Tufan Süelözgen, Salih Budak, Mustafa Karabıçak, Taha Çetin, Yiğit Yalçın, Zafer Kozacıoğlu
İzmir Tepecik Eğitim ve Araştırma Hastanesi

Amaç
Çalışmanın amacı,üreteronoskopi (URS) yapılan çocuk hastalarda taşsızlık oranını ve bunu etkileyen faktörleri değerlendirmektir.

Gereç-Yöntem
Kasım 2010-Aralık 2015 arasında üreter taşı tanısı ile URS ameliyatı yapılan 67 çocuk hasta çalışmaya alındı.Hastaların yaş, cinsiyet, taş boyutu (mm), lokalizasyon(distal-orta-proksimal), intraoperatif ve post operatifkomplikasyonlar, ek girişim gerekliliği değerlendirildi. Taşsızlık durumu kontrastsız abdominal bilgisayarlı tomografi ile postoperatif 30. günde değerlendirildi.

Bulgular
Hastaların ortalama yaşı 6,12±5,45 (0-15) yıl arasında ve 22 hasta (%32,8) erkek idi. Çalışmaya alınan hastaların ortalama taş boyutu 9,33±4,22 (5-16) mm idi.Taşların lokalizasyonu 13 hastada proksimal(%19,4), 41 hastada distal(%61,1) idi.61 hastada(%91) taşlar tamamen temizlendi. 2 hastada idiyopatik üreter darlığı nedeni ile taşa ulaşılamadı,4 hastada taş böbreğe kaçtı.Bu hastaların hepsine stent takıldı.Peroperatif komplikasyon gelişmedi.Postoperatif dönemde 1 hastada ürosepsis gelişti ve uygun antibiyoterapi ile serviste hasta tedavi edildi.
Sonuç
Çocuk hasta grubunda üreter taşlarının tedavisinde URS başarılı ve güvenli bir tedavidir.

Results of ureteroscopy in pediatric patients: A single center experience

Rahmi Gökhan Ekin, Yusuf Özlem İlbey, Tufan Süelözgen, Salih Budak, Mustafa Karabıçak, Taha Çetin, Yiğit Yalçın, Zafer Kozacıoğlu
Izmir Tepecik Teaching and Research Hospital

In this study, outcome of pediatric patients who underwent ureterorenoscopy (URS) treatment in our clinic are evaluated.

Matherials and METHODS:
We reviewed the records of all patients up to age 18 years in whom urolithiasis was treated with URS from November 2010 to December 2015. A total of 67 pediatric patients was included the study. Patients were evaluated age, sex, stone size (mm), stone location (distal, mid, proximal), intraoperative and postoperative complications and secondary intervention. Stone-free status was evaluated with noncontrast computed tomography at postoperative 30 day.

RESULTS:
The mean age was 6,12±5,45 (0-15) years. The study included 22 boys (%32,8). The mean stone size was 9,33±4,22 (5-16) mm. The locations were as follows: 13 (19,4%) in the proximal, 41 (%61,1) in distal ureter. The overall stone-free rate with the ureterorenoscopy was 91% (61/67). Reason of unsuccessful procedure in 6 patients. idiopathic urethral stricture in 2 patients, stone push back to the kidney in 4 patients. Ureteral stent inserted in all 6 patients. There were no peroperative complications. In 1 patients, postoperative urosepsis was developed, and then this patients received an appropriate course of antibiotics.

Sixteen patients are included the study and their mean age was 65,19±6,36 (60-72) years.

Incontinence was occured after transurethral prostate surgery for 4 (25%) patients, after radical prostatectomy for 12 (75%) patients. Preoperative mean diaper test was 823,67±331,27 (222-1800) gr. and all patients have normocomplian bladder. Average time between prostatic surgery and AUS placement is 33,21±21,89 (9-76) months. Eight (50%) patients had minimal postoperative urine leakage symptom and their mean diaper test was 25,12±9,89 (12-44) gr. AUS was removed in 5 patients due to mechanical device problem in 2 patients, urethral erosion in 2 patients and wound infection in 1 patient. Mean AUS removing time was 39,60±21,32(2-56) months.

CONCLUSIONS:
URS is a safe and successful treatment option in pediatric patients.