Abstract
Purpose
We sought to investigate the association between renal stone composition and percutaneous nephrolithotomy outcomes in pediatric patients and define the characterization of the stone composition.
Methods
The data of 1157 children who underwent percutaneous nephrolithotomy between 1991 and 2012 were retrieved from the multicenter database of the Turkish Pediatric Urology Society. The study population comprised 359 children (160 girls, 199 boys) with stone analyses. Patients were divided into five groups according to the stone composition [group 1: calcium oxalate; group 2: calcium phosphate; group 3: infection stones (magnesium ammonium phosphate, ammonium urate); group 4: cystine; group 5: uric acid, xanthine stones].
Results
Patient characteristics, perioperative, postoperative, and stone characteristics were compared considering the stone composition. There were no significant differences between the groups concerning age, sex, side involved, preoperative hematocrit levels, and solitary renal unit. Patients with cystine stones were more likely to have a history of stone treatment. Groups 2 and 5 had mostly solitary stones. However, group 3 had staghorn stone more often, and group 4 frequently had multiple stones. Overall stone-free rate (79.4%) was similar among the groups. Although stone composition was related to blood transfusion and prolonged operative and fluoroscopy screening times on univariate analysis, it was not a significant predictor of them on multivariate analysis.
Conclusions
Stone composition was not a predictor of outcomes of pediatric percutaneous nephrolithotomy. However, cystine and infection stones, which are larger and filled multiple calyxes due to the nature of stone forming, were more challenging cases that need multiple tracts.
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Funding
For this work, Bulent Onal was supported by Scientific Research Projects Coordination Unit of Istanbul University, Project number 1030-24135.
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OK: project development, data collection or management, data analysis, manuscript writing/editing. FAT: data collection or management. NS: data collection or management. EÖ: data collection or management. ST: data collection or management. HSD: data collection or management. MMP: data collection or management. Vİ: data collection or management. ŞS: data collection or management. HK: data collection or management. TÇ: data collection or management. AÖ: data collection or management. ST: data collection or management. BÖ: project development, data collection or management, data analysis, manuscript writing/editing
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All procedures performed in this study that involved human participants were in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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The authors declare that they have no conflict of interests.
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Kaygısız, O., Türegün, F.A., Satar, N. et al. Renal stone composition does not affect the outcome of percutaneous nephrolithotomy in children. World J Urol 36, 1863–1869 (2018). https://doi.org/10.1007/s00345-018-2325-4
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DOI: https://doi.org/10.1007/s00345-018-2325-4