# Risk factors for prolonged urine leakage following pediatric percutaneous nephrolithotomy: A comparative study of lithotripsy techniques

## TL;DR

This study identifies risk factors for prolonged urine leakage in children after kidney stone surgery, finding that laser lithotripters increase the risk compared to pneumatic ones.

## Contribution

The study specifically compares lithotripsy techniques and identifies risk factors for prolonged urine leakage in pediatric PCNL.

## Key findings

- Laser lithotripters significantly increase the risk of prolonged urine leakage compared to pneumatic lithotripters.
- Larger access diameters, larger stone sizes, and younger age are associated with increased risk of PUL.
- Conservative management without DJ stents is effective in most cases of PUL.

## Abstract

This study aimed to identify the risk factors associated with prolonged urine leakage (PUL) following pediatric percutaneous nephrolithotomy (PCNL) with a specific focus on the impact of lithotripter type.

Data from 847 pediatric PCNL patients treated between August 1997 and February 2024 were collected. Patients were categorized into two groups based on the urine leakage time: prolonged leakage (> 24 h) and normal leakage. Logistic regression analysis was used to identify determinants of prolonged urine leakage.

The study found that the use of laser lithotripters (LL) significantly increased the risk of prolonged urine leakage compared with pneumatic lithotripters (PL) (OR, 3.1; 95% CI: 1.68–5.76, p < 0.001). Additionally, larger access diameters (≥ 26 Fr), larger stone sizes (> 350 cc), and younger age (< 6 years) were associated with an increased risk of PUL. Patients who underwent procedures with multiple accesses were also at a higher risk of PUL. Despite this, conservative management without the use of DJ stents is effective in most cases.

The use of PL in pediatric cases is associated with a lower risk of PUL than LL. Factors such as the access diameter, stone size, and patient age can predict the likelihood of PUL. Conservative management is recommended in most patients to avoid increased morbidity.