الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 144 |  |  |
| | | from | 144 | | |
Abstract
Pediatric stone disease is one of the most common urological issues in pediatric urology practice. The incidence of urinary stone disease is increasing in children in last decades.
The three main treatment options available for pediatric stones treatment are extracorporeal shock wave lithotripsy (ESWL), ureteroscopy (rigid and flexible), percutaneous nephrolithotomy (PCNL) and open surgery that has been reserved for complex stones associated with abnormal anatomy.
Modern endoscopic treatment options together with ESWL allow individualized management of stone disease in the pediatric population.
ESWL is still a valuable option in the pediatric population. however most of the children undergoing extracorporeal shock wave lithotripsy (ESWL) need general anesthesia, which means that in case of ESWL failure, the child will again need an exposure to general anesthesia to undergo another procedure of ureteroscopic lithotripsy
Advancements in flexible ureteroscopes have the greatest impact in changing endourology. smaller sizes scopes and advancement in optics, instrumentations and optics make it easier to access the whole urinary tract.
The aim of this work to assess the safety, efficacy and outcome of flexible ureteroscopy using holmium Yttrium aluminium garne (YAG) laser lithotripsy and compare its results with that of Extracorporeal shock wave lithotripsy EWSL in management of ureteric stones in pediatric age group.
To achieve this goal, this study was done over 40 patients with upper ureteric stones less than or equal 1cm in size. It was a a randomized double armed clinical trial with 20 patients in each arm. Patients in group A were treated by ESWL,while patients in group B were treated by flexible ureteroscopy and laser lithotripsy.
Stone free rate was 70% in group A while it was 85 % in group which indicates high stone free rate post flexible URS.
15 % of patients in group A developed moderate hematuria, while this occurred only in 5 % of patients in group B. all were managed by intravenous fluids and bed rest.
Post-operative fever occurred in 5 % of patient in group A compared by 20% of patients in group B.
Mean operative time was 38.95 +/- 6.95 minute in group A while it was 65.15 ± 9.72minute in group B which indicates less operative time in ESWL group.
Mean hospital stay was 4.3 ± 0.11 hours in group A while it was 34.80 ± 12.85 hours in group B, which indicates less hospital stay post ESWL.
30% of patient in group A needed retreatment while in group B there wasn’t any patients needed retreatment, which indicate high retreatment rate in ESWL group
All patients in both groups suffered from pain in day one post-operatively. However, (25%) of patients in group A required usage of analgesics in the form of NSAID for at least 24 hours compared to (50%) of patients in group B.