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Safety and efficacy of retrograde intrarenal surgery (RIRS) in pediatric patients: Insights from a single-center

Nadeem Bin Nusrat1, Assad Ur Rehman1, Shujah Muhammad1

  • 1Department of Urology, Pakistan Kidney and Liver Institute and Research Centre (PKLI & RC), Lahore, Pakistan.

Urologia
|February 9, 2026
PubMed

Insights

Retrograde Intrarenal Surgery (RIRS) is safe and effective for pediatric urolithiasis, achieving high stone clearance. Anatomical abnormalities may reduce complications, while larger stones decrease clearance success.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Nephrolithiasis Management

Background:

  • Pediatric urolithiasis management increasingly utilizes minimally invasive techniques.
  • Retrograde Intrarenal Surgery (RIRS) shows promise, but pediatric outcome data is limited.

Purpose of the Study:

  • To assess the safety and efficacy of RIRS in children with kidney or upper urinary tract stones.
  • To identify predictors of successful outcomes and complications following pediatric RIRS.

Main Methods:

  • Retrospective observational study of 24 pediatric patients (<14 years) undergoing RIRS for stones up to 27 mm.
  • Data collected included demographics, stone characteristics, surgical details, complications, and follow-up imaging.
  • Multivariate logistic regression analyzed predictors of complications and stone clearance.

Main Results:

  • Complete stone clearance was achieved in 70.8% of patients.
  • Postoperative complications occurred in 20.8%, with sepsis in 16.7%.
  • Anatomical abnormalities were associated with fewer complications (p=0.037), while stones >15 mm reduced clearance odds (p=0.009).

Conclusions:

  • RIRS is a safe and effective treatment for pediatric urolithiasis with a high stone-free rate.
  • Anatomical abnormalities may be protective against complications; larger stone size impacts clearance.
  • Selective RIRS use with careful preoperative assessment can optimize outcomes in children.
Abstract

Keywords:
access sheath failurepediatric urolithiasispostoperative complicationsretrograde intrarenal surgery (RIRS)stone clearance

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