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Is Retrograde Intrarenal Surgery as Safe for Children as It Is for Adults?

Mehmet Serkan Ozkent1, Mehmet Mesut Piskin2, Mehmet Balasar2

  • 1Department of Urology, Konya City Hospital, Konya, Turkey.

Urologia Internationalis
|July 11, 2021
PubMed

Insights

Retrograde intrarenal surgery (RIRS) is equally safe and effective for children and adults with kidney stones. Stone size and lower calyx location negatively impact stone-free rates in RIRS procedures.

Area of Science:

  • Urology
  • Pediatric Surgery
  • Endourology

Background:

  • Kidney stones affect both pediatric and adult populations.
  • Retrograde intrarenal surgery (RIRS) is a minimally invasive treatment option.

Purpose of the Study:

  • To compare the efficacy and safety of RIRS in children versus adults with similar kidney stone burdens and locations.
  • To identify factors influencing stone-free rates (SFRs) after RIRS.

Main Methods:

  • Retrospective comparison of perioperative outcomes, SFRs, and complication rates (CRs) between pediatric (n=55) and adult (n=220) patients.
  • Flexible ureterorenoscopy performed with identical instruments.
  • Multivariate analysis to determine factors affecting SFR.

Main Results:

  • No significant differences in SFRs (pediatric: 81.8%; adult: 78.2%) or complication rates (13.8% overall, mostly Clavien I-II) between groups.
  • Higher rates of JJ stenting and ureteral access sheath (UAS) use in the pediatric group.
  • Stone size and lower calyx location were identified as negative predictors for SFR.

Conclusions:

  • RIRS demonstrates comparable safety and efficacy in pediatric and adult patients.
  • Technical variations in RIRS between age groups are minimal.
  • Stone size and lower calyx location are key factors affecting RIRS success.
Abstract

Keywords:
EndourologyNephrolithiasisRetrograde intrarenal surgeryStone diseaseUrolithiasis

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