Genitourinary Intervention in Children

ABSTRACT

Pediatric nonvascular genitourinary intervention requires the operator to consider pediatric sedation concerns, equipment and catheter and technique modifications because of the small size of the patient, and congenital anomalies. The infant or small child must be kept warm during the procedure. General anesthesia is usually not necessary for drainage procedures or nephrostomy tube placement. Ureteral stenting occurs less frequently in children than in adults but is often used in cases of postsurgical scarring. Shorter and lower profile nephrostomy and drainage tubes improve chances of retention and success. Procedures in the infant and young child, particularly percutaneous nephrostomy and nephrolithotomy, can be quite challenging but may result in preservation of renal parenchyma. Percutaneous stone removal is enabled by flexible small endoscopes, decreased width of tract dilatation, and use of small caliber peel-away sheaths. Percutaneous drainage of a urinoma or instillation of antifungal agents via nephrostomy tube may also be renal preserving. Ultrasound guidance, in conjunction with fluoroscopy, is ideal for percutaneous procedures in children.

KEYWORD

Nephrostomy - pediatric - interventional

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