Comparison of ESWL and RIRS for 2 Cm Lower Pole Renal Pelvis and Kidney Stones in Preschool Children

Objective: Surgically treating urinary tract stones in paediatric patient groups, especially in the preschool period, is more difficult than that in adult patient groups. For paediatric patients, non-invasive methods have many advantages and disadvantages. In this study, we compared the success rates of extracorporeal shock wave lithotripsy (ESWL) and retrograde intrarenal surgery (RIRS) for the treatment of lower pole renal pelvis and kidney stones. Methods: Patients who had lower pole renal pelvis and kidney stones and were subjected to RIRS and ESWL in our clinic between March 2016 and October 2019 were retrospectively reviewed. The success rates and duration of anaesthesia were compared in terms of the size, localisation and hardness of the stones. Results: Surgical success was achieved in 17 (80.9%) of 21 patients who underwent RIRS in the study and in 14 (73.6%) of 19 patients who had ESWL. No relationship was found amongst the size, location, Hounsfield degree and stone-free (SF) rate in either of the methods. RIRS and ESWL had 50% and 60% SF in the lower pole of the kidney, respectively. Conversely, the SF rate in the renal pelvis was around 80%. The anaesthesia duration for RIRS was longer in the successful cases than in the unsuccessful ones, whereas it was just the opposite in ESWL group so anaesthesia duration was longer in the unsuccessful cases. Conclusion: ESWL and RIRS can be successfully applied to preschool children. They have similar success rates in terms of stone treatment. Therefore, the optimal technique should be used individually in each patient.