الفهرس 
Introduction and aim of studyOnly 14 pages are availabe for public view
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Abstract
Pediatric urolithiasis with an overall incidence of around 2-3 per cent is relatively rare. Excluding the endemic areas, ureteric stones constitute a small proportion of the overall stone load. Adequate management depends on the size, stone position and anatomy of the urinary tract and on the age of the patient.
Technological developments, including the miniaturization of endoscopic equipment, and the increasing experience of urologists enabled not only decreasing the lower age limit for children seeking care but also increasing the efficacy of disintegrating of calculi found in the upper urinary tract. Pneumatic, electro-hydraulic, ultrasonic, and laser lithotripters have been used for URS treatment. Small caliber ureteroscopes with laser lithotripsy are the traditional management for pediatric ureteral stones and have provided a more safe management with lower complication rates .
In this study, we have prospectively assessed our experience of using semi-rigid ureteroscopy using pneumatic lithotripter in treatment of pediatric ureteric stones at Urology department , Minia university, Nephrology and Urology hospital .
Forty children underwent ureteroscopy for ureteric calculi were included in this study . The research was performed using semiregid ureteroscope . Ureteric orifice dilation was done by passing the ureteroscope .
Stones were disintegrated using penumatic litotripter with large fragments extraction. Ureteral stents were placed in all cases at the end of the procedure.
In the current research, the outcome of 40 children underwent ureteroscopy with the use of a semi-rigid ureteroscope for middle and lower ureteric stones was described. Our overall stone-free rate was 92.5% and 92.3 % for lower and middle ureteric stones respectively . Three cases had post operative residual stones; one case because there was ureteric perforation so we had to end the procedure , the other two cases had a large stone burden. A secondary ureteroscopy was done for all cases after one month.
In our study , all cases showed no hydronephrosis on 3-6 month follow up by ultrasonography .
The findings of our research have shown that small diameter semi-rigid ureteroscope with pneumatic lithotripsy is a safe and effective way of treating ureteric stones in children.