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S10-5
(P)
PREDICTING THE NEED FOR PASSIVE URETERAL DILATION PRIOR TO
URETEROSCOPIC STONE REMOVAL
Christopher LONG, Sagar KADAKIA, Dana WEISS, David CHU, Aseem SHUKLA and Arun SRINIVASAN
Children's hospital of Philadelphia, Surgery, division of Urology, Philadelphia, USA
PURPOSE
Ureteroscopy (URS) is a recognized first line therapy for pediatric renal stones. When URS is precluded by an inability to
access the ureter, ureteral dilation can be performed actively with coaxial dilators or passively with a ureteral stent. We
sought to examine predictors of pre-stenting requirement prior to URS.
MATERIAL AND METHODS
All patients undergoing URS from January 2004-December 2014 were assessed for demographic information, urologic
history, and stone characteristics. Univariate analysis was performed to identify clinical factors predicting the need for
pre-operative stenting.
RESULTS
279 patients underwent 372 procedures in the inclusion period. There were 170 (60%) females and 109 (40%)
males. Median age in the pre-stented group was younger compared to the non-stented group (12.9 vs. 15.4 years,
p<0.05). Ethnicity, gender, and stone size (5 vs. 6mm, p= NS) did not differ between the two groups. Rates of
ureteral anomalies (UPJ obstruction, etc.) did not differ between the two groups. Pre-stenting was required less often in
patients with a neurogenic bladder (11.7% vs. 21%, p<0.05) but was required more often in renal compared to ureteral
stones (50% vs. 32.9%, p<0.05). Previous ureteral surgery was not associated with an increased need for pre-
stenting. Median pre-operative stent duration was 20 days.
CONCLUSIONS
Pre- stenting prior to URS was required more often in younger children and for renal stone location. Stenting was less
likely in those with a history of neurogenic bladder. These findings can guide pre-operative counseling and prepare a
family for multiple potential interventions for successful URS.