Time to Reach Stone-free Status in Children Undergoing Retrograde Intrarenal Surgery
Süleyman Tagcı1, Gökhan Demirtaş2, Bilge Karabulut3
1Ankara Bilkent City Hospital, Department of Pediatric Urology, Turkey. suleyman_tagci@hotmail.com.
Insights
Retrograde intrarenal surgery (RIRS) can achieve stone-free status in children within 12 months. Extended follow-up is recommended, as stone clearance may take longer, especially for complex stones.
Area of Science:
- Pediatric Urology
- Nephrolithiasis Management
Background:
- Retrograde intrarenal surgery (RIRS) is increasingly utilized for pediatric renal stone disease.
- Significant variability exists in reported stone-free rates (SFR) for RIRS in children.
- Limited data addresses the time required to achieve stone-free status post-RIRS in pediatric populations.
Purpose of the Study:
- To evaluate the time to reach stone-free status after RIRS in children.
- To determine the overall stone-free rates (SFR) in pediatric patients undergoing RIRS.
Main Methods:
- Retrospective analysis of pediatric patients who underwent RIRS.
- Ultrasonography used for stone clearance assessment at three-month intervals for 18 months.
- Analysis of SFR and time to achieve stone-free status.
Main Results:
- 105 children (mean age 6.66 years) were evaluated; 75.5% achieved stone-free status.
- Mean time to stone-free status was 12.25 months, with a median follow-up of 29 months.
- Staghorn stones required longer clearance times (mean 16.85 months) compared to single stones (mean 10.23 months), though not statistically significant.
Conclusions:
- Stone-free status in children following RIRS can be achieved up to 12 months post-procedure.
- Extended follow-up is crucial due to the prolonged time to stone clearance.
- Avoid immediate re-intervention for asymptomatic residual stones; allow adequate time for spontaneous clearance.
Purpose:
Retrograde intrarenal surgery has become increasingly popular for renal stone disease but has very different stone-free rates in children. There is insufficient data in the literature regarding how long it takes to reach a stone-free status in children after retrograde intrarenal surgery. We aimed to evaluate the time to reach stone-free status and stone-free rates (SFR) in children who underwent retrograde intrarenal surgery.
Materials And Methods:
This retrospective study included children who had undergone retrograde intrarenal surgery. Ultrasonography was performed three months after the procedures for 18 months to evaluate stone clearance. We analyzed the stone-free rate and time to reach stone-free status.
Results:
One hundred and five patients (mean age 6.66 + 5.27 years) were evaluated. Fifteen patients had staghorn stones, 31 had multiple stones, and 44 had single stones. The median follow-up period was 29 months (9-44 months) Of the 90 patients who underwent RIRS as the first treatment option, 38 (42.2%) achieved stone-free status with a single procedure, while 30 (33.3%) required repeat RIRS and other procedures.The stone-free rate was achieved in 75.5% of the patients in a mean of 12.25+40.19 months, In the group with staghorn stones, stone-free status was achieved in 4-36 months with a mean of 16.85+12.03 months, in patients with multiple stones in 2-41 months with a mean of 12.72+10.03 months, and in patients with single stones in 1-36 months with a mean of 10.23+9.10 months. Although the staghorn group achieved stone-free time for longer than the other two groups, there was no significant relationship between the three groups (P = .131) and achieved stone-free time.
Conclusion:
A stone-free status can be achieved in children 12 months after retrograde intrarenal surgery. Since stone-free status is achieved over a long period, patient follow-ups should be planned accordingly, and there should be no rush to perform additional interventions in asymptomatic cases with residual stones.
