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CONGRESS OF THE ESPU
MATERIAL AND METHODS
We prospectively performed retrograde ureteroscopy and supine PCNL in children with ureteric
stones and ipsilateral renal calculi during the period Jan 2015 to Sept 2017. Inclusion criteria were:
age younger than 18 years, Presence of ipsilateral ureteric calculi and renal calculi. Exclusion
criteria included: contraindications to general anesthesia, attendant different illness such as coagu-
lation abnormalities. All procedures were performed with the patient in the supine Valdivia modified
Galdakao position.
RESULTS
During the study period, a total number of 39 children (23 males and 16 females) presenting with
symptomatic ureteric and ipsilateral renal calculi underwent retrograde ureteroscopy and supine
PCNL in a single setting. The mean age was 14 years. The mean operating time was 95 mins. None
of the children needed intra or postoperative blood transfusions. The mean drop in hemoglobin
following the procedure was 0.5 gm%. Our initial stone clearance rate with combined ureteroscopy
and PCNL was 84.6 % and following SWL for residual fragments stone clearance was 100 % in all
children at 3 months follow-up.
CONCLUSIONS
In this study of ours we have been able to tackle both ureteric calculi and ipsilateral renal calculi in
a single setting using the GMSV position in children. The combined procedure of ureteroscopy and
ipsilateral PCNL in GMSV position was feasible, safe and effective and was associated with minor
postoperative complications.
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Discussion
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S23-4 (PP)
LONG-TERM RESULTS IN PRIMARY OBSTRUCTIVE
MEGAURETER TREATED BY ENDOSCOPIC BALLOON
DILATION
Ruben ORTIZ, Alberto PARENTE, Laura BURGOS and José María ANGULO
Hospital Universitario Gregorio Marañón, Pediatric Urology Division, Department of Pediatric Surgery, Madrid, SPAIN
PURPOSE
To assess long-term effectiveness, complications and outcomes of primary obstructive megaureter
(POM) treated by endoscopic balloon dilation (EBD) in the largest series reported.
MATERIAL AND METHODS
100 POM in 92 consecutive patients were treated by EBD between years 2004–2016. A total of
79 POM (73 patients) with more than 18 months of follow-up after treatment have been analyzed.
EBD of the vesicoureteral junction was performed with semicompliant high-pressure balloon
catheters (2.7FG) with minimum balloon diameter of 5 mm, followed by temporary Double-J stent
placement. Follow-up protocol included periodical clinical reviews, US and MAG-3 renogram scans.
RESULTS
Median age at surgery was 4 months (15 days-3.6 years), with median operating time of 20 minutes
(10–60) and hospital stay of 1 day (1–7). Initial renal function was preserved in all patients with
normalization of the renogram elimination curves. Significant differences were observed in ureteral
diameter before, after EBD and in long-term (p<0.001). Endoscopic approach of POM had a long-
term success rate of 87.3 %, with a mean follow-up of 6.4±3.8 years. Secondary VUR was found in
17 cases (23 %), being successfully treated by endoscopic subureteral injection in 13 (76,4 %). Nine