Micro-ureteroscopy (m-URS) for treatment of upper ureteral stones in children: A new, different approach.

A four-year-old girl with left pain was admitted to our clinic. Computer tomography scan revealed a 5.8 x 5 mm calculus in the left upper ureter and hydronephrosis. The procedure was performed with the patient in the lithotomy position under general anesthesia using the standard URS technique with a m-URS that had a caliber of 4.85 Fr. m-URS, a 3-part all-seeing needle, consisting of micro-optics with a diameter of 0.9 mm and a 120-degree angle of view, an irrigation channel, and an integrated light (PolyDiagnost, Pfaffenhofen, Germany). After the guidewire (0.022”) was sent to the ureter, a 4.85 Fr micro sheath was sent over the second guidewire (0.035”) up to the stone under fluoroscopy. Then, a micro-optic and a laser set were placed in the sheath. Stone fragmentation was performed with a 272-μm Holmium laser fiber with a frequency of 10 Hz and power of 0.5 joules. Irrigation was provided by the gravity effect 70 cm above the patient. The irrigation pump was not used. At the end of the operation, no ureteral stent was placed.