Passive dilation by ureteral stenting before ureteroscopy: eliminating the need for active dilation.

Abstract

We sought to evaluate the use of passive dilation by stenting of ureteral orifices that were inaccessible at initial cystoscopic evaluation in children before a ureteroscopic procedure. We evaluated all patients younger than 18 years undergoing a ureteroscopic procedure in whom the ureteral orifice could not be accessed endoscopically by a ureteroscope. A total of 26 children (14 boys and 12 girls) 7.3 to 14.1 years old (median age 10.3 years) underwent 28 passive dilations of initially inaccessible ureters. Stents remained indwelling for 2 to 8 weeks (median 3). All patients underwent successful ureteroscopy with a semirigid and/or flexible ureteroscope after preoperative stent placement. No patient required active dilation of the ureteral orifice at ureteroscopy. There were no complications from stent placement before the ureteroscopic procedures. No patient had a urinary tract infection or bladder spasms requiring anticholinergic therapy from stent insertion and/or early stent removal. Our study shows that passive dilation of the ureteral orifice in preparation for ureteroscopy is a straightforward, successful and beneficial technique in children, with no associated complications.