Endourology Techniques in Children: Experience of a Nord Africain Center

Abstract

Introduction: Bladder endoscopy in children has been improving over the last few years because of the miniaturization of the instruments. It seems to be now the method of choice for the diagnosis and the management of many pediatric diseases with low morbidity and excellent results. The aim of our study was to discuss the role of cystoscopy in pediatric surgery and to overview its future prospects. Methods: Between January 1st, 2019 to December 31, 2019, patients who underwent a cystoscopy were reviewed retrospectively. This monocentric study has been conducted by the department of Pediatric Surgery in Habib Thameur Hospital., Tunisia. Results: 39 males and 27 females were included in our study.  The average age was three years. The different etiologies were: the vesico-ureteral reflux in 29 patients; pelvi-ureteric junction obstruction in 22 patients, ureterocele in 4 patients, posterior urethral valves in 2 patients, megaureter in 2 patients, and others in 7 patients. The endoscopy was performed for a therapeutic purpose in 60 cases and for a diagnostic one in 6 cases. The endoscopy made it possible to diagnose a bladder tumor and to perform a biopsy, to investigate hematuria or a gender ambiguity, or to exclude. the diagnosis of urethral valves. The urethrocystoscopy was performed for the injection of Deflux®, the treatment of posterior urethral valves, and ureteroceles. It was also used for placing or removing JJ stents. Conclusion: Many instrumental innovations have expanded the indications for bladder endoscopy in children. The field of robotics is also knowing as a big expansion with a high precision of work and great results but the high cost of these technics remains a big challenge in our country.