Pediatric ureteroscopy

What is a pediatric ureteroscopy?

Ureteroscopy (yr·ee·tr·aa·skuh·pee) is a procedure that allows a surgeon to see inside your child’s ureter. Then, by using a small laser, the surgeon can break kidney stones into small pieces that can be removed or passed during urination.

This minimally invasive procedure uses a small telescoping camera that is inserted through the urethra into the bladder. The surgeon then directs the camera into the ureter on the side that has the kidney or ureteral stone. This allows your child’s surgeon to find and break up the stones in the ureter or in the kidney into smaller pieces using a laser.

If your child’s ureter is too narrow for the ureteroscope, your child’s doctor may need to place a stent to widen your child’s ureter for a few weeks before performing a ureteroscopy.

Two surgeries are required in these cases.

1. The first surgery is to place the stent 

2. The second is to treat the stone

If the stone is stuck and there is concern for infection, this placement of the stent will help relieve the blockage. This will allow the normal flow of urine to resume. In these cases, your child will be treated with antibiotics before their ureteroscopy to treat the stone.

What are the benefits of a pediatric ureteroscopy?

The benefits of a ureteroscopy procedure are that it can remove painful kidney stones that are too difficult to pass. With the use of the camera, your child’s surgeon can view the urinary tract in its entirety.

Because a ureteroscopy is minimally invasive, your child’s recovery time is also much shorter than traditional options. Recovery time varies by person, but typical recovery time is about five to seven days.

What are the side effects of a pediatric ureteroscopy?

After a ureteroscopy, a temporary stent is typically left in place. Side effects are usually mild – typically during the time the stent is in place – and can be mostly managed with pain medication. The most common side effect is discomfort from the stent, which can cause a burning sensation or back pain when your child urinates. They may also feel the urge to go to the bathroom without actually producing any urine.

Immediately following the procedure, there may be blood in the urine. This is normal and will last while the temporary stent is in place. Your child may complain of some abdominal pain. Some children may also experience nausea and vomiting after the procedure from anesthesia.

What are the risks of a pediatric ureteroscopy?

The risks with a ureteroscopy procedure are minimal, but there is a small risk of:

• Urinary tract infections (UTI)

• Side effects from the anesthesia

• Damage to the ureters resulting in scarring

Your doctor will discuss these risks with you. At Children’s Health, our extensive experience with this procedure enables us to keep these risks to an absolute minimum.

What are Children's Health's outcome metrics for a pediatric ureteroscopy?

The largest outcome metric is the successful removal of the stones, so kids can get back to being kids.

We also work hard to limit the recurrence of stones in children. Following a ureteroscopy procedure, the specialists at the Pediatric Comprehensive Stone Center will follow up with you and your child. This is to determine the likelihood of more stones developing and what steps can be taken to reduce that risk.

Identifying if your child is at risk for future kidney stones is the first step in protecting their body from the potential damage that repetitive surgeries can cause. The specialists at Children’s Health will help you and your child learn the healthy habits that will reduce their risk of kidney stones.

What to expect with a pediatric ureteroscopy

Pediatric ureteroscopy procedures are typically very successful in treating kidney stones in kids. Children’s Health cautions parents and their children that some patients may require two procedures to fully remove kidney stones if the child’s ureter is too small to accommodate the ureteroscope during the first attempt.

What to expect before a pediatric ureteroscopy

Once the decision is made to perform the ureteroscopy procedure, your child will need to have a preoperative (pre-op) assessment, which usually occurs the day of surgery. This includes answering any final questions you may have about the procedure and your child as well as doing a pre-anesthesia assessment.

What to expect during a pediatric ureteroscopy

Your child will be under general anesthesia during the procedure. While they are asleep, one of the specialists with Children’s Health will place a wire into the ureter using a combination of a cystoscope, a camera and an X-ray. Using the wire, the ureteroscope is guided by the surgeon up through the bladder to the ureter tubes and the stones that are causing the blockage. A laser is then used to break up the stones into smaller pieces before being removed.

A ureteral stent will be placed to allow the kidneys to drain properly and prevent any swelling from blocking the flow.

What to expect after a pediatric ureteroscopy

Most children go home the same day as their procedure. Most kids will recover from their procedure in five to seven days, depending on how long they have the temporary stent. During this time, they may experience pain and discomfort when they urinate. Medications will help to manage the pain and other symptoms as needed.

The temporary stent, which is attached to a string, will be removed at a follow-up appointment. Most children handle this well, but some may experience some anxiety about the removal. You can help your child by reassuring them throughout the process and giving them Tylenol^® before the appointment.

You and your child will have a follow-up appointment with our specialists four to six weeks after their procedure, to see if any other stones have developed. We will also teach you how to prevent stones.

How do I prepare my child for a pediatric ureteroscopy?

Your child will need to go under general anesthesia for the procedure. This means that eating and drinking before the procedure will be limited to keep your child safe. Your doctor and the care team will provide detailed guidelines to follow.

If your child has special health concerns, they may be referred to the Children’s Health pediatric pre-op assessment program before their procedure for a more thorough check-up. This will help the medical team to better treat your child during the procedure.

What questions should I ask my provider about a pediatric ureteroscopy?

• How many ureteroscopy procedures have you performed?

• Will my child need to spend the night at the hospital after their ureteroscopy?

• Are there other treatment options for my child’s kidney stones?

• What medications should my child stop taking before ureteroscopy?

• Will my child go home with any special equipment after ureteroscopy?

• How soon will I be able to see my child after the ureteroscopy?