Modern endoscopic treatment of pediatric urolithiasis: early outcomes of a single-center retrospective study
Year: 2026
Type: article
Study design: Observational Study
Abstract: The aim was to describe stone characteristics and early outcomes of endoscopic treatment for pediatric urolithiasis, reporting ureteroscopy (URS), retrograde intrarenal surgery (RIRS), mini-percutaneous nephrolithotomy (mini-PCNL), and cystolithotripsy separately. This retrospective single-center observational study included 72 children younger than 18 years treated between 01 January 2025 and 12 March 2026. Stone location, size, computed tomography (CT) attenuation, and composition, as well as procedure type, residual fragments, and early complications according to the Clavien-Dindo classification, were assessed. Treatment selection was clinical and nonrandomized. All 72 children underwent postoperative ultrasonography and follow-up low-dose non-contrast CT in one month for standardized residual-fragment assessment. The outcome criterion was the absence of residual fragments >4 mm; fragments ≤4 mm were allowed. Upper urinary tract stones were present in 68 children (94%): renal stones in 47 (65%) and ureteral stones in 21 (29%); bladder stones were present in 4 (6%). Stone size ranged from 4 to 18 mm, with a mean of 8.8 mm and a median of 8 (6; 11) mm. Attenuation ranged from 390 to 1410 HU, with a mean of 895 HU and a median of 1015 (928; 1132.5) HU. Calcium oxalate stones were found in 39 children (54%). URS was performed in 20 children (28%), RIRS in 36 (50%), mini-PCNL in 12 (17%), and cystolithotripsy in 4 (6%). At one month, 71/72 children (99%) met the specified criterion: 20/20 (100%) after URS, 36/36 (100%) after RIRS, 11/12 (92%) after mini-PCNL, and 4/4 (100%) after cystolithotripsy. Three grade I complications (4%) were recorded: two cases of postoperative bleeding after mini-PCNL and one case of pronounced pain after RIRS. These findings describe early institutional outcomes under an explicit criterion and follow-up interval. They do not establish the superiority of any procedure. Meeting the outcome criterion is not equivalent to complete stone clearance. Fourier-transform infrared spectroscopy (FTIR) complements surgery by informing metabolic evaluation and prevention. Long-term recurrence was not assessed.
Source: Medicni perspektivi
Institution: Dnipro State Medical University
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223563252