Flexible ureterorenoscopy and laser lithotripsy using 7.5F pusen direct in-scope suction in the pediatric population – A pilot feasibility and safety case series from a tertiary pediatric endourology referral center
Sohani N. Dassanayake, Mohamed Koura, Stephen Griffin, Bhaskar K. SomaniAbstract
Introduction:
The incorporation of integrated suction systems during flexible ureterorenoscopy and laser lithotripsy (FURSL) may improve intrarenal pressure control and stone clearance. While adult studies suggest superior stone-free rates (SFR), data in pediatric patients remain limited. This study evaluates outcomes of FURSL with direct in-scope suction (DISS) in a pediatric cohort.
Methods:
A retrospective analysis was conducted of pediatric patients (≤16 years) undergoing FURSL with DISS at a tertiary endourology center. Data extracted included patient characteristics, operative details, length of stay, and complications. The primary outcome was cumulative SFR, defined as endoscopic and radiological clearance or residual fragments ≤2 mm. Secondary outcomes included complications and median hospital stay.
Results:
Fourteen patients (7 males, 7 females; mean age 10.5 years, range 2.2–16) underwent 17 procedures. Median stone burden was 18.5 mm (interquartile range 13.3–21.8 mm), with multiple stone locations in five patients. The most common stone location was the lower pole (
Conclusion:
FURSL with DISS appears safe and effective in the pediatric population, achieving high cumulative SFRs with minimal morbidity and short hospital stay. Further prospective comparative studies are warranted.