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Retrograde Intrarenal Surgery in Children: Evolution, Current Status, and Future Trends

Yesica Quiroz1, Bhaskar Kumar Somani2, Yiloren Tanidir3

  • 1Department of Urology, Division of Pediatric Urology, Fundació Puigvert, Barcelona, Spain.

Journal of Endourology
|August 16, 2022
PubMed

Insights

Retrograde intrarenal surgery (RIRS) is a safe and effective treatment for pediatric urolithiasis, showing improved stone-free rates and decreased complications with increased surgeon experience. Further research is needed to optimize its use across all pediatric age groups.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Urolithiasis Management

Background:

  • Pediatric urolithiasis incidence is rising, necessitating advanced treatment options.
  • Retrograde intrarenal surgery (RIRS) offers a minimally invasive approach via natural orifices, avoiding percutaneous access morbidity.
  • This review examines RIRS evolution in children, focusing on age-related anatomical impacts on outcomes.

Approach:

  • A comprehensive literature search was conducted from inception to October 2021 across major databases (PubMed, EMBASE, Web of Science).
  • 51 relevant articles were selected after screening 2022 initial records and 165 full-text articles.
  • Two pediatric urologists synthesized findings on RIRS development and pediatric application.

Key Points:

  • RIRS is now a preferred modality for pediatric urolithiasis over extracorporeal shockwave lithotripsy.
  • Passive dilation reduces the need for active ureteral dilation, though prestenting necessity remains unclear.
  • Ureteral access sheath use is common, but long-term effects on pediatric growth require investigation.

Conclusions:

  • RIRS has significantly improved stone-free rates (SFR) and reduced complications in pediatric patients.
  • Increased surgeon experience correlates with better RIRS outcomes.
  • Further research and larger datasets are essential to establish RIRS as the definitive treatment for all pediatric renal stone cases.

Keywords:
kidney stoneslithotripsypediatric urolithiasisretrograde intrarenal surgeryureteral access sheath

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