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RIRS and mini-PCNL were similarly effective for pediatric high-density renal stones

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Research area:medicine-clinicalurology

What the study found

Both retrograde intrarenal surgery (RIRS, a stone-removal procedure using a flexible scope passed through the urinary tract) and mini-percutaneous nephrolithotomy (mini-PCNL, a smaller-keyhole kidney stone surgery) worked well and were safe in children with single renal pelvic stones under 2 cm and high density on CT. The study found comparable stone-free rates, with some recovery measures favoring RIRS.

Why the authors say this matters

The authors conclude that both procedures are useful for managing pediatric kidney stones in this group. They also suggest that RIRS may offer less invasiveness, shorter recovery, and lower radiation exposure, while mini-PCNL remains a valuable option in anatomically complex or lower-calyceal cases.

What the researchers tested

The researchers conducted a prospective randomized clinical trial at Beni-Suef University Hospitals. They enrolled 70 children aged 3–14 years with a single renal pelvic stone smaller than 2 cm and density above 1000 HU on low-dose non-contrast CT, then randomized them equally to RIRS or mini-PCNL.

What worked and what didn't

At one month, stone-free rates were 91.4% for RIRS and 94.3% for mini-PCNL, and this difference was not significant. RIRS had shorter operative time, hospital stay, catheterization time, and radiation exposure; mini-PCNL had a greater hemoglobin drop, while complication rates were similar between groups.

What to keep in mind

The abstract does not describe longer-term follow-up beyond one month. It also focuses on children with a single high-density renal pelvic stone under 2 cm, so the findings may not apply to other stone types or locations.

Key points

  • The study compared RIRS with mini-PCNL in 70 children aged 3–14 years.
  • Both treatments had high one-month stone-free rates: 91.4% for RIRS and 94.3% for mini-PCNL.
  • RIRS had shorter operative time, hospital stay, catheterization time, and lower radiation exposure.
  • Mini-PCNL produced a greater hemoglobin drop, while complication rates were similar.
  • The authors say mini-PCNL may still be useful in anatomically complex or lower-calyceal cases.

Disclosure

Research title:
RIRS and mini-PCNL were similarly effective for pediatric high-density renal stones
Authors:
Ossama Mahmoud, Mahmoud Abdallah, Ahmed ElSayed Ahmed Abdellatif, Ahmed Hamdy Mostafa, Anas Albudairat, Akram A. Elmarakbi, Hany F. Badawy
Institutions:
Beni-Suef University, Beni-Suef University, Beni-Suef University, Beni-Suef University, Beni-Suef University, Hamad Medical Corporation, Inova Alexandria Hospital
Publication date:
2026-02-03
DOI:
10.1007/s00240-026-01938-x
OpenAlex record:
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AI provenance: This post was generated by gpt-5.4-mini (OpenAI). The original authors did not write or review this post.

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