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What is the best approach for pediatric kidney stones of moderate-sized between shock wave lithotripsy, ultramini percutaneous nephrolithotomy and retrograde intrarenal surgery?

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Abstract

Purpose

This study aimed to compare the results of ultramini percutaneous nephrolithotomy (UMP), shock wave lithotripsy (SWL) and retrograde intrarenal surgery (RIRS) in pediatric patients with kidney stones 10–20 mm size.

Methods

The files of 159 pediatric patients (36 RIRS, 39 SWL, 84 UMP) with kidney stones were reviewed retrospectively. Preoperative age, sex, stone size and location were evaluated. The three methods were compared in terms of operation and fluoroscopy duration, complications with the modified Clavien grading system, and stone-free rate (SFR) in the postoperative first month.

Results

The stone burdens of the groups were similar (P = 0.102). At the end of the first month, SFR was higher in the RIRS and UMP groups compared to the SWL group (88.9%, 92.9% and 69.2%, respectively, P = 0.002). UMP had higher SFR for lower pole stones than the other two methods (P = 0.042). There was no difference in complications between the three methods (P = 0.758).

Conclusion

SFR was similar for all three methods in all localizations, apart from lower pole stones. UMP had higher SFR for lower pole stones than the other two methods. There was no difference in terms of complications between the three methods.

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Authors and Affiliations

  1. Department of Urology, Adana City Teaching and Research Hospital, University of Health Sciences, Adana, Turkey

    Umut Unal, Ferhat Ortoglu, Ediz Vuruskan & Adem Altunkol

  2. Department of Urology, Adana Kozan State Hospital, Ministry of Health, Adana, Turkey

    Mehmet Eflatun Deniz

  3. Depertment of Urology, Adana Seyhan State Hospital, Ministry of Health, Adana, Turkey

    Hakan Anil

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  1. Umut Unal
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  2. Mehmet Eflatun Deniz
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  3. Ferhat Ortoglu
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Contributions

UU, MEF, FO wrote the main manuscript. EV, HA prepare table and researched the literature, all author reviewed the manuscript. AA critical review and corresponding author.

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Correspondence to Adem Altunkol.

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Unal, U., Deniz, M.E., Ortoglu, F. et al. What is the best approach for pediatric kidney stones of moderate-sized between shock wave lithotripsy, ultramini percutaneous nephrolithotomy and retrograde intrarenal surgery?. Pediatr Surg Int 38, 1643–1648 (2022). https://doi.org/10.1007/s00383-022-05203-1

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