Safety And Efficacy Of Retrograde Intrarenal Surgery In Pediatric Stone Disease

Authors : Bülent Altay

Pages : 4-7

View : 21 | Download : 16

Publication Date : 2018-08-13

Article Type : Research

Abstract :Introduction: Percutaneous nephrolitotomy (PNL) has been considered a well established first-line theraphy which may present some problems in preschool-age population for larger stones or in SWL-refractory cases. We reviewed 44 preschool-age children with kidney stones treated with flexible ureteroscopy. Method: We retrospectively reviewed the records of all children with kidney stones younger than 7 years who underwent flexible ureteroscopy (FURS) at our institution between January 2004 and March 2012. Results: The mean patient age was 4.8±1.6 years (range 6 months to 7 years). Twenty-four patients had renal pelvic calculi, 20 patients had polar calculi (9 upper pole, 7 lower pole, 4 midpolar). Ten (22.7%) patients were previously treated for the same stone, including 6 (13.6%) patients with SWL, 2 (4.5%) patients with PNL, whereas 2 (4.5%) patients had only stent placement. There were no significant intraoperative complications. At the first (2 week) evaluation visit 7 (15.9%) patients (4 males and 3 females) has residual fragments of 3-5 mm detected by ultrasonography or KUB/non-contrast CT if needed. The overall stone-free rate after a single procedure at 3 rd  month was found 93.1% (41 patients). No major complications occured. Postoperative complications were recorded in 10 (22.7%) patients, including urinary tract infection (UTI) in 6 (13.6%) (5 females, 1 male) , hematuria in 1 (2.2%) male patient and acute urinary retention (AUR) in 3 (6.8%) male patients, respectively. Discussion: Retrograde Intrarennal Surgery seems to be an important tool in the pediatric urologic armamentarium for treating kidney stones. FURS offers low morbidity of SWL but the potential stone-free rates approaching those of PNL in pediatric patients. To our knowledge, this is the largest series data reported revealed that FURS is very effective and safe in the management of pre-schoo age pediatric population with kidney Stones with a few minor complications. We believe FURS can become a first-line theraphy for these patients.
Keywords : Renal Stone, children, Intrarenal Surgery