FACTORS INFLUENCING THE EFFECTIVENESS OF PROPHYLAXIS OF INFECTIOUS COMPLICATIONS IN RETROGRADE TRANSURETHROL URETEROLITHOTRIPSY

Abstract

Objective: to evaluate prognostic factors influencing the effectiveness and safety of transurethral ureterolithotripsy (TUULT) in pediatric patients.
Materials and methods: during the period from 2010 to 2022, TUULT was performed on 123 children, whose average age was 10.5 ± 4.1 years (range 4 to 17 years). Of these, there were 83 boys (67.4%), while 41 girls (32.6%). TUULT was performed using a rigid 8 Fr endoscope. The average size of the stones was 12.9±1.0 mm, with a density of 726.6±468.3 HU. Stones were located in the distal part of the ureter in 98 (79.6%) children, in the middle part in 12 (9.7%) cases and in the proximal part in 13 (10.7%) patients.
Results: stone free state after one session of TUULT was in 94% of cases. Risk factors were stone size greater than 10 mm, stone density greater than 1000 HU, and disease duration. Using the Clavien-Dindo classification, postoperative complications were observed in 27.6% of cases.
Conclusions: TUULT is an effective method for treating ureteral stones in children. Stone density influences the incidence of complications and residual stones when additional interventions are necessary. The level of complexity and conversion to open interventions is higher in patients with disease duration of more than three months.