Successful Treatment of Multiple Large Intrarenal Stones in a 2-Year-Old Boy Using a Single-Use Flexible Ureteroscope and High-Power Laser Settings

TL;DR

A 2-year-old boy successfully had multiple large kidney stones removed using a single-use flexible scope and high-power laser in one procedure.

Contribution

Demonstrates successful use of single-use flexible ureteroscopes and high-power lasers for complex pediatric kidney stones.

Findings

Multiple large intrarenal stones were successfully removed in a single RIRS session in a 2-year-old.

No complications were recorded with minimal hemoglobin loss and quick recovery.

Single-use flexible ureteroscopes and high-power lasers proved effective in pediatric stone management.

Abstract

The standard treatment procedures for managing renal calculi in the pediatric population are similar to those in adults. The application of flexible ureteroscopy has contributed to the increased popularity of retrograde intrarenal surgery (RIRS) as an alternative therapeutic modality that can be successfully applied in children. One of the most significant innovations of the last decade is the introduction of single-use flexible ureteroscopes (fURSs). In this case report, we present the case of a 2-year-old boy with multiple large calculi in his right kidney, which were successfully removed after a single session of RIRS using a 7.5 F single-use fURS and high-power laser settings. The total operative and lithotripsy times were estimated at 90 and 75 min, respectively. No complications were recorded. The hemoglobin loss was calculated at 0.3 mg/dL, while the creatinine level was decreased by 0.1 mg/dL. The urethral catheter was removed on the first postoperative day, and the patient was discharged. The management of multiple or large kidney stones is very challenging in the pediatric population under the age of three years. Convenient preoperative planning and the appropriate use of available equipment may lead to excellent outcomes accompanied by a reduced risk for complications.

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