Comparison of Stone-Free Rate Following Percutaneous Nephrolithotomy and Extracorporeal Shock Wave Lithotripsy for Renal Pelvic Stones (1–1.5 cm) in the Pediatric Population (6–14 Years)
DOI:
https://doi.org/10.52206/jsmc.2025.15.4.1306Abstract
Background: Urolithiasis is increasingly common in children and may lead to long-term renal complications
Objective: To compare stone-free rates and early complications in children with renal pelvic stones (1.0–1.5 cm) treated by mini-percutaneous nephrolithotomy (mini-PCNL) versus extracorporeal shock wave lithotripsy (ESWL).
Methodology: A randomized controlled trial was conducted at Khyber Teaching Hospital, Peshawar (October 2024–March 2025), including 124 children aged 6–14 years. Participants were randomized into two equal groups: mini-PCNL or ESWL. Stone clearance was assessed four weeks post-treatment using X-ray and ultrasonography.
Results: Stone-free status was achieved in 95.1% of mini-PCNL and 61.2% of ESWL patients (RR: 1.55, 95% CI: 1.25–1.91). Minor complications were more frequent with ESWL, including hematuria (12.9%), UTI (16.1%), and abdominal pain (9.6%), while no major complications occurred.
Conclusion: Mini-PCNL achieved higher stone-free rates and fewer complications than ESWL for pediatric renal pelvic stones of 1.0–1.5 cm, supporting its use as the preferred treatment option.
Keywords: Complications, ESWL, Mini-PCNL, Pediatric urolithiasis, Stone-free rate.
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