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.
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http://dx.doi.org/10.22037/uj.v21i.8270 | DOI Listing |
Int J Urol
December 2024
Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan.
Objectives: To evaluate the success rate of shock wave lithotripsy and identify predictors of stone-free status after shock wave lithotripsy for ureteral stones, focusing on the impact of stones remaining in the same location for 2 months (SSL2).
Methods: A retrospective analysis was conducted on 501 patients with ureteral stones treated with shock wave lithotripsy by expert surgeons (each with over 1000 shock wave lithotripsy operations) at a single Japanese institution in 2020. Logistic regression analysis identified predictors of stone-free status, including stone length, skin-to-stone distance, stone density (Hounsfield Unit), Hounsfield Unit above/below the stone, stone position, and duration of stone at the same location (SSL2).
Int Urol Nephrol
December 2024
Department of Urology, Unidade Local de Saúde de Santo António, Centro Hospitalar Universitário Do Porto, 8th floor, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal.
Introduction: The primary aim of stone treatment is to achieve stone-free status. Residual fragments can cause stone growth, recurrence, urinary tract infections, and ureteric obstruction. Our goal was to describe the natural history of stone burden after retrograde intrarenal surgery (RIRS) based on stone-free status (SFS), evaluating stone growth and stone-events.
View Article and Find Full Text PDFArch Ital Urol Androl
October 2024
Department of Urology, Faculty of Medicine, Universitas Udayana, Denpasar, Bali; Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali.
Introduction: Percutaneous Nephrolithotomy (PCNL) has been performed in various positions, including prone position and several modifications of supine position. The Barts flank-free modified supine (FFMS) position is a newly enhanced version of the supine positions. This study aims to compare the outcomes of Barts FFMS and prone position in PCNL.
View Article and Find Full Text PDFEur Urol Open Sci
January 2025
Urolithiasis Guidelines Panel, European Association of Urology, Arnhem, The Netherlands.
Background And Objective: Stone size has traditionally been measured in one dimension. This is reflected in most of the literature and in the EAU guidelines. However, recent studies have shown that multidimensional measures provide better prediction of outcomes.
View Article and Find Full Text PDFNiger Med J
November 2024
Department of Surgery, University of Benin Teaching Hospital, Benin-City, Edo State, Nigeria.
Background: This study is therefore aimed at assessing upper urinary tract stone characteristics, the outcome of retrograde intrarenal surgery with laser lithotripsy, and factors predicting stone-free status.
Methodology: This was a retrospective cross-sectional study carried out on all patients who had retrograde intra-renal surgery with laser lithotripsy for upper urinary tract stones from 2021-2023 at the Urology unit, department of Surgery, University of Benin Teaching Hospital. Electronic medical records were retrieved with data on demographics, serum calcium level, and non-contrast computed tomography scans assessing stone size, location, laterality, multiplicity, density, and renal anatomy.
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