• Humans
• Kidney Calculi/surgery
• Nephrolithotomy, Percutaneous/methods
• Retrospective Studies
• Child
• Female
• Male
• Adolescent
• Treatment Outcome
• Operative Time
• Length of Stay/statistics & numerical data
• Child, Preschool
• Postoperative Complications/epidemiology

• Cystinuria
• Hypercalciuria
• Hyperoxaluria
• Hyperuricosuria
• Hypocitraturia
• Lithotripsy
• Nephrolithiasis
• Nephrolithotomy

• Child
• Humans
• Kidney Calculi
• Glomerulonephritis
• Sodium Chloride

Percutaneous nephrolithotomy is usually considered as safe and effective in the management of renal stones in pediatric population. Urinothorax defined as presence of urine in pleural cavity is a rare complication of percutaneous nephrolithotomy. We present a rare case of slowly developing urinothorax in a 9-year-old boy following PCNL due to migration of DJ stent into the pleural cavity. The case was managed by intracostal tube drainage and repositioning of DJ stent.

The current study retrospectively reviewed data for all children and adolescents who underwent mini-percutaneous nephrolithotomy (PCNL) at Ibn Sina Hospital and Sabah Al Ahmad Urology Centre in Kuwait over 10 years. Accordingly, the 40 patients underwent mini-PCNL. Among them, 21 patients (52.5%) had varying degrees of hydronephrosis, with mild to moderate severity accounting for nearly half of them, whereas six (15%) had multiple stones. The median operative time was 54.5 (43.3-64) minutes. Moreover, 11 patients needed flexible ureteroscopy (URS) and double-J (DJ) ureteric stent, and one patient required DJ ureteric stent only. None of the cases developed intraoperative bleeding. The median hospital stay of the included patients was three (2.3-4) days. Residual stone was observed in 11 patients (27.5%), with a median size of 3 (2 to 7) mm. The incidence of postoperative complications was 27.5% (n = 11 patients), with three patients experiencing postoperative bleeding (7.5%) and eight patients developing a fever (20%). All patients had mild postoperative pain. However, no leakage, sepsis, or pelvic injury occurred. None of the patients required revision. In conclusion, mini-PCNL was a safe and effective procedure in children and adolescents with renal stones.

Mini percutaneous nephrolithotomy (MPCNL) is a newer surgical procedure that has changed the management of paediatric renal stones.

To evaluate MPCNL morbidity and success rates for renal stones as a function of patient age in a paediatric cohort.

This was a retrospective case series that included 143 consecutive patients younger than 17 yr who underwent MPCNL at our institution between January 2016 and November 2020. The patients were categorised into three different age groups: <6 yr (n = 71, 49.7%), 6–11 yr (n = 44, 30.8%), and 12–17 yr (n = 28, 19.6%). MPCNL was performed in all patients through 16–20Fr tracts.

The stone-free rate, perioperative complications, tract number, operative time, postoperative haemoglobin change, and hospitalisation time were evaluated for each age group.

MPCNL was performed in 143 paediatric patients (88 boys and 55 girls; mean age 6.53 yr). The mean stone burden (± standard deviation) was 2.096 ± 1.01 cm in group one, 2.05 ± 1.05 cm in group two, and 3.46 ± 19.94 cm in group three; group three was significantly larger (p = 0.001). After a single MPCNL session, 92.42% of patients experienced complete stone clearance. All age groups were similar in terms of stone-free rate (p = 0.82), hospitalisation time (p = 0.94), postoperative haemoglobin change (p = 0.06), and perioperative complications (p = 0.62). However, stone size (p = 0.009), stone complexity (p = 0.001), number of access points (p = 0.03), and operative time (p = 0.009) were higher in the group aged 12–17 yr.

MPCNL is an effective and safe procedure in younger as well as older children. Age should not be considered a limiting factor for MPCNL in children, and MPCNL should be considered the primary option for treating paediatric renal stones when PCNL is indicated.

Our results show that surgical removal of kidney stones through an incision in the skin and using miniaturised instruments is an effective and safe procedure for children.

Introduction: Percutaneous nephrolithotomy (PCNL) has almost completely replaced open surgery for kidney stones because of continuous advancements in the method since the first PCNL was performed in 1976. The aim of this study is to compare the characteristics and outcomes of adult patients and pediatric patients who had undergone PCNL.

Methodology: A retrospective study was conducted at the Sindh Institute of Urology and Transplantation (SIUT) Hospital in Karachi, Pakistan. It included the data of patients who underwent PCNL from January 2015 to January 2022 at the SIUT hospital. The primary outcome variable was the stone-free rate (SFR). Secondary outcomes included length of hospital stay, and complications were assessed using modified Clavien classification system

Results: There is no significant difference in the SFR at discharge between pediatric and adult patients (86.67% vs 88.69%, p=0.634). There is no significant difference between the two groups in relation to the total length of hospital stay (p=0.446). Moreover, 12.50% and 11.11% of adults and children developed complications, respectively, after the procedure. The percentages are not significantly different between the two groups (p=0.266).

Conclusion: The current study using standardized and consistent PCNL techniques shows that SFR is similar in both adults and children, and there is no difference in complications between adults and children.

• pediatric
• surgery
• treatment
• update
• urolithiasis

• failure to thrive
• haematuria
• metabolic disorders
• paediatric surgery
• urinary tract infections

• Percutaneous nephrolithotomy
• children
• complication
• kidney calculi
• stone free rate

• child
• decision support techniques
• nomograms
• percutaneous nephrolithotomy
• treatment outcome

To compare the efficacy and safety of miniature semi-rigid ureteroscopy (URS) with holmium (Ho)-yttrium-aluminium-garnet (YAG) laser lithotripsy vs shockwave lithotripsy (SWL) for treating upper urinary tract (UUT) calculi >1 cm in children.

Children with unilateral single UUT ureteric stones of >1 cm were prospectively enrolled in this study. Patients were randomly divided into two groups: Group 1, treated with SWL; and Group 2, treated with URS (6/7.5 F) and laser lithotripsy. The patients’ characteristics, stones demographics, operative time, adjunctive procedures, stone-free rate (SFR), re-treatment rate, and complications were statistically analysed and compared. Success was defined as stone-free status (no stone residual of ≥0.3 cm) at 1 month from the initial treatment without any auxiliary procedures.

In all, 68 patients with UUT stones met our inclusion criteria. There were no significant differences between the two groups for patient or stone demographics. In Group 1, the SFR was 26/34 (76.4%) and in Group 2 it was 33/34 (97.1%) (P = 0.03). A total of 12 auxiliary procedures in Group 1 and two in Group 2 were needed to reach a 100% SFR (P = 0.014). There were no significant differences between the two groups for operative times, adjunctive procedures, number of complicated cases or complications of Grade ≥III (P = 0.65, P = 0.23, P = 0.77, and P = 0.62, respectively).

Miniature semi-rigid URS with Ho-YAG laser lithotripsy for UUT ureteric stones of >1 cm in children was more effective than SWL in terms of SFR and re-treatment rate, with no significant difference in the rate or grade of complications.

EQ: efficiency quotient; KUB: plain abdominal radiograph of the kidneys, ureters and bladder; RCT: randomised controlled trial; SFR: stone-free rate; SWL: shockwave lithotripsy; URS: ureteroscopy; US: ultrasonography/ultrasound; URS: ureteroscopy; UUT: upper urinary tract; YAG: yttrium-aluminium-garnet

• Paediatric
• laser
• shockwaves
• upper urinary tract
• ureteroscopy

• Mini-PCNL
• Pediatric
• Percutaneous nephrolithotomy
• Percutaneous renal surgery
• Urolithiasis

• Percutaneous nephrolithotomy
• pediatric
• staghorn renal stone
• urolithiasis

• lithotripsy
• nephrolithiasis
• operative
• pediatric
• therapeutics

• Basket retrieval
• Endoscopic nephrolithotomy (ENL)
• Endourology
• Extracorporeal shockwave lithotripsy (ESWL)
• Laser lithotripsy
• Percutaneous cystolithotomy (PCCL)
• Urolith

• Child
• Humans
• Kidney Calculi
• Lithotripsy
• Stents

• Pediatric renal stones
• renal stones
• stone- free rate
• tubeless PCNL

• ESWL
• Endourology
• Extracorporeal shock wave lithotrips
• Mini-percutaneous nephrolithotomy
• Pediatric renal stone

• Child
• Child, Preschool
• Extracorporeal Shockwave Therapy/adverse effects
• Extracorporeal Shockwave Therapy/methods
• Female
• Humans
• Kidney Calculi/therapy
• Male
• Nephrolithotomy, Percutaneous/adverse effects
• Nephrolithotomy, Percutaneous/methods
• Prospective Studies
• Treatment Outcome

• children
• laparoscopy
• pyelolithotomy
• pyeloscopy
• urolithiasis

• Percutaneous nephrolithotomy (PCNL)
• children
• endoscopy
• micropercutaneous (Microperc)
• renal stones

• Mini
• nephrolithotomy
• pediatric
• percutaneous
• renal calculi

Management of kidney stone disease in pediatric population is a challenging condition in urology practice. While the incidence of kidney stone is increasing in those group, technological innovations have conrtibuted to the development of minimally invasive treatment of urinary stone disease such as mini-percutenous nephrolitotomy (mini-PCNL), micro-PCNL, ultra mini-PCNL. In this review we tried to evaluate the effect of new teratment techniques on pediatric kidney stones.

• Percutaneous nephrolithotomy
• Pediatric
• Kidney stone
• Urolithiasis

The incidence of kidney stones in children is increasing. While guidelines exist for acute surgical intervention, there is limited data to inform the decision as to when to intervene non-urgently.

To identify patient and stone characteristics predicting stone surgery in children.

Retrospective chart review.

Stollery Children’s Hospital, Edmonton, Alberta, Canada from 1990 to 2013.

Sixty-three children aged 0–18 years old who presented with a total of 142 stones.

Patient’s surgical history, demographics, metabolic measures, and stone number, type, and location.

Univariate and multivariate analysis, controlling for presentation number and individual-level variation by repeated measures analysis were conducted to assess for patient and stone characteristics associated with surgical intervention.

Sixty-five percent (41/63) required surgery during a mean follow-up of 19 months. Stone characteristics associated with surgical intervention by multivariate analysis included larger stone size (>6 mm), and stone composition of calcium oxalate.

Single center study with a limited sample size and duration of follow up, thereby limiting predictive power. There were some missing data (i,e. stone type was not always available). Despite this, stone type remained significant in multivariate modeling.

Stone size > 6mm and composition with calcium oxalate but not patient age or symptoms associated with presentation predicted surgical intervention. These observations can be used to inform decisions as to whether urolithiasis should be surgically managed electively or observed.

The online version of this article (doi:10.1186/s40697-015-0057-6) contains supplementary material, which is available to authorized users.

• Kidney stone surgery
• Pediatrics
• Urolithiasis

• Endourology
• Infant
• Nephrolithiasis
• Surgical treatment

• Paediatric
• Percutaneous nephrolithotomy
• Renal calculi

• Adolescent
• Analgesics/therapeutic use
• Blood Transfusion
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Kidney Calculi/therapy
• Length of Stay
• Lithotripsy
• Male
• Nephrostomy, Percutaneous
• Retrospective Studies
• Treatment Outcome

Urolithiasis is a common disease that affects urinary tract in all age groups. Both in adults and in children, stone size, location, renal anatomy, and other factors, can influence the success of treatment modalities. Recently, there has been a great advancement in technology for minimally invasive management of urinary stones. The epoch of open treatment modalities has passed and currently there are much less invasive treatment approaches, such as percutaneous nephrolithotomy, ureteroscopy, shockwave lithotripsy, and retrograde internal Surgery. Furthermore, advancement in imaging technics ensures substantial knowledge that permit physician to decide the most convenient treatment method for the patient. Thus, effective and rapid treatment of urinary tract stones is substantial for the preservation of the renal function. In this review, the effects of the treatment options for urinary stones on renal function have been reviewed.

• Kidney stones
• Chronic kidney disease
• Estimated glomerular filtration rate
• Renal function
• Urinary stone disease

• Adult
• Aged
• Female
• Humans
• Kidney Calculi/surgery
• Lithotripsy/methods
• Lithotripsy/statistics & numerical data
• Male
• Middle Aged
• Minimally Invasive Surgical Procedures/statistics & numerical data
• Nephrostomy, Percutaneous/methods
• Nephrostomy, Percutaneous/statistics & numerical data
• Outcome Assessment, Health Care
• Postoperative Complications
• Retrospective Studies

The recurrence of pediatric nephrolithiasis, the morbidity of repeated open surgical treatment as well as our experience in percutaneous nephrolithotomy (PNL) in adult patients, all derived us to shift to PNL for managing renal stones >1.5 cm in pediatric patients. Our aim of this study is to evaluate the safety and efficacy of PNL in pediatric patients.

During the period of the month between May 2011 and April 2013, 38 children (47 renal units) underwent PNL for renal stones 1.5-5 cm in length. Patient demographics, stone characteristics, and clinical outcome were prospectively studied. Data of those who underwent conventional and tubeless PNL were compared. Median follow-up period was 12 months (range: 6-24).

The median age at presentation was 8-year (range: 3-12). The operative time ranged from 30 to 120 min (median 90). Overall stone clearance rate was 91.5% after single PNL. The median hospital stay was 3 days. Auxiliary procedures were successful for the remaining 4 patients (nephroscopic clearance in one and shockwave lithotripsy in 3). Tubeless PNL was performed in 17 renal units with a comparable outcome to conventional ones. The perioperative complications were noted in 5/47 (10.6%) of all procedures (Clavien Grade II in 4 and Clavien Grade IIIa in 1) and were managed conservatively.

Percutaneous nephrolithotomy for renal stones in pediatric patients is safe and feasible if performed by a well-experienced endourologist. Tubeless PNL is a better choice for children.

• Nephrolithiasis
• pediatric urolithiasis
• percutaneous nephrolithotomy
• tubeless percutaneous nephrolithotomy

As almost any version of percutaneous nephrolithotomy (PCNL) was safely and efficiently applied for adults as well as children without age being a limiting risk factor, the aim of the study was to compare the different characteristics as well as the efficacy, outcome, and safety of the pediatric and adult patients who had undergone mini-PCNL (MPCNL) in a single institution.

We retrospective reviewed 331 renal units in children and 8537 renal units in adults that had undergone MPCNL for upper urinary tract stones between the years of 2000–2012. The safety, efficacy, and outcome were analyzed and compared.

The children had a smaller stone size (2.3 vs. 3.1 cm) but had smilar stone distribution (number and locations). The children required fewer percutaneous accesses, smaller nephrostomy tract, shorter operative time and less hemoglobin drop. The children also had higher initial stone free rate (SFR) (80.4% vs. 78.6%) after single session of MPCNL (p<0.05); but no difference was noted in the final SFR (94.7% vs. 93.5%) after auxiliary procedures. The complication rate (15.6% vs. 16.3%) and blood transfusion rate (3.1% vs. 2.9%) were similar in both group (p>0.05). Both groups had low rate of high grade Clavien complications. There was no grade III, IV, V complications and no angiographic embolization required in pediatric group. One important caveat, children who required multiple percutaneous nephrostomy tracts had significant higher transfusion rate than in adults (18.8% vs. 4.5%, p = 0.007).

This contemporary largest-scale analysis confirms that the stone-free rate in pediatric patients is at least as good as in adults without an increase of complication rates. However, multiple percutaneous nephrostomy tracts should be practiced with caution in children.

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Child, Preschool
• Demography
• Female
• Humans
• Infant
• Male
• Middle Aged
• Nephrostomy, Percutaneous/methods
• Postoperative Complications/etiology
• Young Adult

• NGB
• PCNL
• SWL
• URS
• bacteriuria
• calculi
• morbidity
• neurogenic
• neurogenic bladder
• percutaneous nephrostolithotomy
• shock wave lithotripsy
• ureteroscopy
• urinary bladder