Introduction: As the role of paediatric ureteroscopy (URS) for stone disease increases, new methods of stone treatment such as dusting and pop-dusting have emerged. However, outcomes of treatment using these laser settings in paediatric age group is still largely unknown. We aimed to look at the feasibility and outcomes of URS and pop-dusting using a high-power 100W laser for paediatric stone patients.
Material and methods: Outcomes from a prospective stone database were reviewed over a period of 30 months from February 2016-July 2018. All paediatric patients (≤16 years) treated with dusting and pop-dusting were included in our study. Dusting and pop-dusting were performed using Ho:YAG laser with the energy setting ranges of 0.2-0.5 J and 0.5-0.7 J respectively with a frequency of 20-50 Hz.
Results: Twelve patients underwent URS and treatment using this method with mean age of 6.5 years and a male:female ratio of 7:5. The mean and cumulative single stone size was 7.1 mm (3-10 mm) and 11.9 mm (6-40 mm) respectively with half of all patients having multiple stones. Eleven patients were stone free on follow-up with no intra or post-operative complications noted.
Conclusions: Pop-dusting using holmium laser is a new hybrid technique that allows for more efficient dust formation even for hard stones. This is the first clinical study demonstrating the safety and efficacy of this technique in paediatric patients. It is likely there will be wider adoption of these new laser techniques for stone treatment in the paediatric age group.
Keywords: dusting; fragmentation; laser; paediatric; pop-dusting; popcorn; stone; ureteroscopy.
Copyright by Polish Urological Association.