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A 5-year-old girl underwent a pyelolithotomy and dismembered pyeloplasty for a right staghorn calculus. A 1-cm calculus could not be removed, and a nephrostomy tube was left in place. Prior to her planned extracorporeal shock wave lithotripsy treatment, the calculus moved into her distal ureter. Ureteroscopy was performed, with extraction of the calculus. Intravenous urograms after 1 month and again 1 year later demonstrated improved renal function and anatomy and no adverse sequelae from the procedure. On the basis of this initial experience (our youngest child so treated) and three additional children described herein, we believe that ureteroscopy is a potential alternative to ureterolithotomy in selected pediatric cases.
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Arsdalen et al. (1989) studied this question.
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