Guidewire for Retrograde Passive Dilatation of Ureter in Pediatric Patients with Urolithiasis: A Novel Technique from a Tertiary Center in Nepal

Abstract

Objective of the Study: We sought to evaluate the role of guidewire placement as ureteral stent in passive ureteral dilatation for uretero-renoscope negotiation in pediatric patients. Study Designs: This was a prospective cross-sectional study. Place and Duration of the Study: Department of Urology, Manmohan Memorial Medical College and Teaching Hospital, Kathmandu, Nepal, (December 2019 to November 2020). Methodology: All pediatric patients (<18 years) diagnosed with more than 6mm size of distal ureter stone undergoing ureteroscopic lithotripsy under general anesthesia in which ureteroscope (4.5/6.5 Fr) negotiation and double J (DJ) ureteral stent (4 Fr) insertion could not be successful in first sitting were selected for the study. Data collection included demographics, clinical parameters, and perioperative and postoperative complications of those patients undergoing preoperative ureteral stenting with guidewire for 2 weeks for ureteroscopic management of ureteric stone after removal of guidewire. The statistical analysis of data was done using Microsoft Excel. Results: A total of 12 (41 %) cases underwent passive dilatation of ureter with guidewire. The mean age of the patients and mean stone size were 8.42 ± 1.7 years and 6.1 ±0.65mm respectively. None of the patients developed intraoperative and postoperative complications related to the procedure. Conclusion: Guidewire placement as ureteral stent for 2 weeks would result sufficient passive ureteral dilatation for the ureteroscope negotiation without any complication. PUD with guidewire is safe and effective. Additional research is necessary to determine whether the findings will be similar or not.