Login to Access Video or Poster Abstract: MP68-07
Sources of Funding: None

Introduction

Bilateral simultaneous retrograde intrarenal surgery in children has the potential advantages of omitting the need for second intervention together with reducing cost and length of hospital stay. Aim of the current study is to assess the safety and feasibility of this approach in children.

Methods

Twenty four children with a mean age of 11.5 years were prospectively enrolled in this study. Technique of simultaneous removal of the upper urinary tract stones on both sides consisted of removal of the stone from the kidney or the ureter of the technically less complicated side followed by the removal of the stone on the contralateral side. Stones were arranged in renal collecting system in both side (n=8), and in ureters on both sides (n=10) and the remaining (n=6 pts) on one side in the kidney, another side in the ureter.

Results

Mean stone size of both renal unit and ureter ranged from 8 to 22 (14.6 mm) and 5-12 (7.2 mm) respectively. Mean operating time was 98 minutes. Mean hospital stay was 2.4 days. Stone free rate was 83.3% after a single session. Complications included ureteric perforation and extravasation (n=2), postoperatively, moderate hematuria (n=4) and febrile UTI (n=2) requiring intravenous antibiotics. Four patients (16.6%) needed auxiliary procedures for complete recovery of the residual stones in the form of ESWL (n=3) and PCNL (n=1)

Conclusions

Bilateral simultaneous retrograde intrarenal surgery in children is safe and feasible with good stone clearance and low morbidities. It eliminates the need for repeated anesthesia and psychological stress associated with multiple interventions. However, this practice should be restricted to tertiary referral centers with high stone volume.

Funding

None