Children’s kidney stones: PCNL and flexible ureteroscopy may perform similarly

A prospective randomised single-blinded study compared percutaneous nephrolithotomy (PCNL) with retrograde intrarenal surgery using single-use flexible ureteroscopy (FURS) in children under 18 with renal stones of 10 to 30 mm. Stone-free rates were 91.3% after PCNL and 88.6% after FURS, a difference that was not statistically significant. The primary outcome was complications, graded by the Clavien-Dindo system. Mean operative time was shorter with PCNL, at 78.8 minutes compared with 94.2 minutes.

Radiation exposure and fluoroscopy time were higher with PCNL, which was also linked to longer hospital stays. The reporting does not discuss Indian practice or where the trial was conducted. For Indian units, PCNL's shorter operating time may need to be weighed against greater radiation exposure and longer stays.