Prospective randomized comparison of mini percutaneous nephrolithotomy and retrograde intrarenal surgery for pediatric renal stones (10–30 mm)

Background Kidney stones in children have unique characteristics, including a smaller pelvicalyceal system and more delicate tissues. This work aimed to compare the safety and efficacy of retrograde intrarenal surgery using single-use flexible ureteroscopy (FURS) with mini-percutaneous nephrolithotomy (PCNL) in children with renal stones measuring 10–30 mm. Methods This prospective, randomized single blinded study was conducted in children with renal stones measuring 10–30 mm. Patients were randomized into two groups: Group I underwent mini PCNL, and Group II underwent FURS. Result Ninety children completed the study. Operative time and postoperative stenting were significantly lower in the mini PCNL group than in the FURS group ( P < 0.001). Fluoroscopy time was significantly higher in the mini PCNL group than the FURS group ( P < 0.001). The stone-free rate and complication rates were not significantly different between the two groups. Hospital stay was significantly lower in the FURS group ( P < 0.001). Conclusion Mini-PCNL and single-use FURS are both safe and effective for treating 10–30 mm renal stones in children, with comparable stone-free rates and complication profiles. Mini-PCNL offers a shorter operative time but involves longer fluoroscopy time and hospital stay. FURS is associated with a higher rate of post-operative DJ stenting.