title: Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney.
abstract: BACKGROUND
  Management of renal stones in children with a solitary kidney is a challenge. In the current study, the efficacy and safety of retrograde intrarenal surgery (RIRS) in these children were determined.
  
  
  METHODS
  Records of children with renal stones who were treated at our institute between August 2011 and August 2014 were retrospectively assessed. Inclusion criteria were: Children with single renal stone <2 cm size, in a solitary kidney. A 7.5 Fr flexible ureteroscope (FURS) was introduced into the ureter over a hydrophilic guidewire under visual and fluoroscopic guidance - applying a back-loading technique. The stone was completely dusted using 200 μm laser fiber (0.2-0.8 joules power and 10-30 Hz frequency). At the end of the maneuver, a 5 Fr JJ stent was inserted into the ureter. The children were discharged home 24 h postoperative - provided that no complications were detected.
  
  
  RESULTS
  Fourteen children (3 girls and 11 boys) with median age 9.5 years (range 6-12) were included. The mean stone burden was 12.2 ± 1.5 mm (range 9-20). Stones were successfully accessed in all of the cases by the FURS except for 2 cases in whom a JJ stent was inserted into the ureter and left in place for 2 weeks to achieve passive dilatation. All of the stones were dusted completely. The immediate postoperative stone-free rate (SFR) was 79%, and the final SFR was 100% after 3 weeks. No intraoperative complications were observed.
  
  
  CONCLUSIONS
  RIRS for renal stone <2 cm in children with a solitary kidney is a single-session procedure with a high SFR, low complication rate, and is a minimally invasive, natural orifice technique.
authors.affiliation: Department of Urology, Sohag University Hospital, Sohag, Egypt.
authors.forename: Wael Mohamed
authors.initials: WM
authors.lastname: Gamal
authors.affiliation: Department of Urology, Sohag University Hospital, Sohag, Egypt.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Hussein
authors.affiliation: Department of Urology, Sohag University Hospital, Sohag, Egypt.
authors.forename: El Nisr
authors.initials: EN
authors.lastname: Rashed
authors.affiliation: Department of Urology, Sohag University Hospital, Sohag, Egypt.
authors.forename: Al-Dahshoury
authors.initials: AD
authors.lastname: Mohamed
authors.affiliation: Department of Urology, Sohag University Hospital, Sohag, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mmdouh
authors.affiliation: Department of Urology, Sohag University Hospital, Sohag, Egypt.
authors.forename: Farag
authors.initials: F
authors.lastname: Fawzy
keywords: Pediatric; solitary kidney; stone