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Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
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Updated: Sep 12, 2025

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Supine mini PCNL in infants using conventional cystoscope.

Heera Tharanendran1, Ramesh Babu1, Mathisekaran Thangarasu1

  • 1Asian Institute of Nephrology and Urology, Chennai, 600034, India.

Journal of Pediatric Urology
|August 5, 2025
PubMed
Summary

A simplified supine mini percutaneous nephrolithotomy (PCNL) technique for infants offers a minimally invasive option for kidney stone removal. This approach uses standard pediatric urology instruments, improving accessibility and patient recovery.

Keywords:
PCNL-cystoscopePaediatric mini-PCNLSupine-PCNL

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Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Nephrolithotomy

Background:

  • Presents a simplified technique for supine mini percutaneous nephrolithotomy (PCNL) in infants.
  • Utilizes conventional compact cystoscopes and commonly available pediatric urology instruments.
  • Enhances accessibility, particularly in resource-limited settings.

Purpose of the Study:

  • To describe a modified mini PCNL approach for infants.
  • To evaluate its feasibility, safety, and efficacy.
  • To reduce invasiveness and improve recovery in pediatric patients.

Main Methods:

  • Supine positioning with flank elevation and extended lithotomy.
  • Retrograde placement of a 3Fr ureteric catheter via cystoscopy.
  • Fluoroscopic guidance for lower/mid calyx puncture, sheath insertion, and Holmium:YAG laser lithotripsy.
  • Antegrade DJ stent insertion for fragment clearance.

Main Results:

  • Five infants (median age 15 months) with pelvic stones (13-19 mm) were treated.
  • Mean operative time was 40 minutes.
  • No complications were reported, with complete stone clearance at 1-year follow-up.

Conclusions:

  • The modified supine mini PCNL is minimally invasive, enhancing recovery in infants.
  • Supine positioning improves anesthetic safety and avoids repositioning.
  • Further studies are recommended to validate long-term outcomes.