Time to Reach Stone-free Status in Children Undergoing Retrograde Intrarenal Surgery

Purpose: Retrograde intrarenal surgery has become increasingly popular for renal stone disease but has very different stone-free rates in children. There is insufficient data in the literature regarding how long it takes to reach a stone-free status in children after retrograde intrarenal surgery. We aimed to evaluate the time to reach stone-free status and stone-free rates (SFR) in children who underwent retrograde intrarenal surgery. Materials and Methods: This retrospective study included children who had undergone retrograde intrarenal surgery. Ultrasonography was performed three months after the procedures for 18 months to evaluate stone clearance. We analyzed the stone-free rate and time to reach stone-free status. Results: One hundred and five patients (mean age 6.66 + 5.27 years) were evaluated. Fifteen patients had staghorn stones, 31 had multiple stones, and 44 had single stones. The median follow-up period was 29 months (9-44 months) Of the 90 patients who underwent RIRS as the first treatment option, 38 (42.2%) achieved stone-free status with a single procedure, while 30 (33.3%) required repeat RIRS and other procedures. The stone-free rate was achieved in 75.5% of the patients in a mean of 12.25+40.19 months, In the group with staghorn stones, stone- free status was achieved in 4-36 months with a mean of 16.85+12.03 months, in patients with multiple stones in 2-41 months with a mean of 12.72+10.03 months, and in patients with single stones in 1-36 months with a mean of 10.23+9.10 months. Although the staghorn group achieved stone-free time for longer than the other two groups, there was no significant relationship between the three groups (P = .131) and achieved stone-free time. Conclusion: A stone-free status can be achieved in children 12 months after retrograde intrarenal surgery. Since stone-free status is achieved over a long period, patient follow-ups should be planned accordingly, and there should be no rush to perform additional interventions in asymptomatic cases with residual stones.