Retrograde intrarenal surgery using a flexible ureterorenoscope in children with urolithiasis
- Authors: Surov R.V.1, Shmyrov O.S.1, Lazishvili M.N.1, Kulaev A.V.1,2, Sharkov S.M.1,3, Morozov K.D.1, Kovachich A.S.1, Lobach A.Y.1, Margieva D.A.1
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Affiliations:
- Morozovskaya Children’s City Clinical Hospital
- Peoples’ Friendship University of Russia
- The First Sechenov Moscow State Medical University
- Issue: Vol 15, No 3 (2025)
- Pages: 307-316
- Section: Original Study Articles
- URL: https://ogarev-online.ru/2219-4061/article/view/343610
- DOI: https://doi.org/10.17816/psaic1926
- EDN: https://elibrary.ru/KFWFWU
- ID: 343610
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Abstract
BACKGROUND: Extracorporeal shock wave lithotripsy remains the first-line therapy in children with renal stones up to 2 cm. Recently, retrograde intrarenal surgery has become an alternative technology for fragmenting stones located in the renal pelvis and calyces.
AIM: The work aimed to perform a retrospective analysis of the outcomes and complications of flexible ureterorenoscopy in children with urolithiasis.
METHODS: The study included 63 children (65 renal units) who underwent retrograde intrarenal surgery. A total of 70 procedures were performed, including nephrolithotripsy in 59 cases (84.3%) and flexible ureterolithotripsy in 4 cases (5.7%). Nephrolithoextraction and ureterolithoextraction with a flexible endoscope were also performed. Stone size, volume, and density were assessed. The statistical association between the stone-free rate after retrograde intrarenal surgery and other parameters was analyzed using the Mann–Whitney test, Spearman correlation, and logistic regression.
RESULTS: The median age of the patients was 11.8 years. Computed tomography revealed a median stone size of 13.2 mm and density of 1481 HU. After primary retrograde intrarenal surgery, complete stone clearance was achieved in 49 children (77.81%); after repeat intervention for residual fragments, the overall stone-free rate reached 93.66% (59 patients). Only 2 patients (3.17%) developed ureteral colic due to residual ureteral fragments after stent removal, requiring urgent intervention. Statistically significant predictors of residual fragments included initial stone size >1.6 cm on computed tomography and simultaneous stone location in both the pelvis and calyx (p < 0.05). No association was found between stone-free rate and patient age.
CONCLUSION: The method of retrograde intrarenal surgery in children demonstrated a high stone-free rate and a low incidence of significant complications.
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##article.viewOnOriginalSite##About the authors
Roman V. Surov
Morozovskaya Children’s City Clinical Hospital
Author for correspondence.
Email: rimvs@mail.ru
ORCID iD: 0000-0001-9081-8321
SPIN-code: 3964-1815
MD, Cand. Sci. (Medicine)
Russian Federation, MoscowOleg S. Shmyrov
Morozovskaya Children’s City Clinical Hospital
Email: moroz-uro@mail.ru
ORCID iD: 0000-0002-0785-0222
SPIN-code: 1228-5484
MD, Cand. Sci. (Medicine)
Russian Federation, MoscowMarina N. Lazishvili
Morozovskaya Children’s City Clinical Hospital
Email: pedurology@bk.ru
ORCID iD: 0000-0002-1892-7328
SPIN-code: 9632-8895
MD, Cand. Sci. (Medicine)
Russian Federation, MoscowArtur V. Kulaev
Morozovskaya Children’s City Clinical Hospital; Peoples’ Friendship University of Russia
Email: arturkulaev@gmail.com
ORCID iD: 0000-0002-6758-2442
SPIN-code: 7887-3930
MD, Cand. Sci. (Medicine)
Russian Federation, Moscow; MoscowSergey M. Sharkov
Morozovskaya Children’s City Clinical Hospital; The First Sechenov Moscow State Medical University
Email: sharkdoc@mail.ru
ORCID iD: 0000-0001-8579-2227
SPIN-code: 4637-6392
MD, Dr. Sci. (Medicine), Professor
Russian Federation, Moscow; MoscowKirill D. Morozov
Morozovskaya Children’s City Clinical Hospital
Email: dr.kirillmorozov@mail.ru
ORCID iD: 0000-0002-6300-1102
SPIN-code: 7627-5889
Russian Federation, Moscow
Anton S. Kovachich
Morozovskaya Children’s City Clinical Hospital
Email: dr.kov@inbox.ru
ORCID iD: 0000-0001-9758-4441
SPIN-code: 8779-2685
Russian Federation, Moscow
Aleksey Yu. Lobach
Morozovskaya Children’s City Clinical Hospital
Email: uro@alobach.ru
ORCID iD: 0000-0001-8337-3774
SPIN-code: 5788-6720
Russian Federation, Moscow
Diana A. Margieva
Morozovskaya Children’s City Clinical Hospital
Email: dimarodnik93@mail.ru
ORCID iD: 0009-0002-7186-2241
SPIN-code: 9508-5500
Russian Federation, Moscow
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