Efficacy of Different Surgical Methods in the Treatment of Pediatric Urolithiasis: Retrograde Intrarenal Surgery, Ekstracorporeal Shock Wave Lithotripsy and Open/Laparoscopic Surgery Approaches

Abstract Aims: To evaluate the stone-free success of retrograde intrarenal endoscopic surgery, extracorporeal shockwave lithotripsy and open/laparoscopic surgery methods that we applied to urinary system stones detected in the pediatric patient group in our clinic. Materials and Methods: In this study, we retrospectively analyzed the data of 302 pediatric patients who underwent RIRS and RIRS combined with ESWL, open stone surgery, laparoscopic stone surgery for urolithiasis between January 2013 and October 2020 in our clinic. The demographic data of the patients, the side and size of the stones detected by imaging methods, surgical stone interventions, stone-free results and the postoperative hydronephrosis status were evaluated. Results: Of the patients included in the study, 160 (53%) were boys and 142 (47%) were girls. The mean age was 89.719 months (SD 51.447, range 6–216). The mean size of the treated stones was 7.964 mm (SD 3.516, range 2.2-25). In the radiological examinations, stones were detected in 409 renal units. Side distribution of stones was 194 (47.43%) on the right and 215 (52.57%) on the left. Stone-free status was achieved in 262 (86.75%) of the patients in postoperative follow-up. No stones were found on imaging in 235 (77.81%) of these patients. In the follow-up, it was observed that hydronephrosis completely resolved in 278 (92.05%) patients. Conclusion:In conclusion, it is appropriate to prefer minimally invasive surgical methods, especially in pediatric cases. It should not be forgotten that open or laparoscopic surgery, especially laparoscopy, has a place in selected cases, according to the experience of the surgeon.