title: Retrograde intrarenal surgery in infants and preschool-age children.
abstract: OBJECTIVE
  The objectives of this study are to present our experience with retrograde intrarenal surgery for management of renal calculi in children less than 7 years old and to determine its safety and efficacy in this age group.
  
  
  METHODS
  Patient demographics, stone location and size, use of ureteral access sheath, stone-free status, complication rates, and follow-up were evaluated.
  
  
  RESULTS
  A total of 16 patients (9 boys and 7 girls; mean age, 4.2 years) underwent 17 procedures. The mean stone size was 11.5 mm (8-17 mm). Flexible ureteroscopy and laser lithotripsy were performed in all cases regardless of stone location. Dilation of the ureteral orifice was required in 5 cases (29.4%), and ureteral access sheaths were placed in 3 patients (17.6%). With a mean follow-up of 10.3 months, 88% of the children were stone free. The success rate for stones less than 10 mm was 100% and 81.8% for stones 10 mm or more (P < .05). There were no major complications, but there was 1 case of perforation and extravasation at the ureterovesical junction after balloon dilation that was managed with stent placement.
  
  
  CONCLUSIONS
  Retrograde intrarenal surgery is a safe and effective method for the treatment of intrarenal calculi, and it achieves reasonable results with minimal complications in children less than 7 years old.
authors.affiliation: Department of Urology, Ministry of Health, Kecioren Training and Research Hospital, Ankara 06380, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Unsal
authors.forename: Berkan
authors.initials: B
authors.lastname: Resorlu
mesh_terms: D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D008096:Lithotripsy; D017602:Lithotripsy, Laser; D008297:Male; D008659:Metabolic Diseases / Q000150:complications; D011183:Postoperative Complications / Q000453:epidemiology; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D018666:Ureteroscopy / Q000379:methods*