Percutaneous nephrolithotomy in infants: evaluation of a single-center experience

Objective: To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) in infants (<3 years) with renal calculi.

Methods: From November 2005 to August 2010, 20 renal units with calculi in 19 infants (13 boys and 6 girls) were treated with PCNL at our institution. Mean age of infants was 20.6 months (range, 7-36 months), the mean stone size was 2.2 cm (range, 1.9-3.1 cm). All PCNL procedures were performed with 14 to 16F percutaneous access and 8/9.8F rigid ureteroscope. Stones were fragmented with a pneumatic lithotripter and evacuated.

Results: Mean operative time was 77.5 minutes (range, 35-120 minutes). Stones were completely removed in 85% of kidneys (17 of 20 kidneys) after the first session and 95% (19 of 20 kidneys) after a second look PCNL procedure. No patients required a blood transfusion. Evaluation of the renal function before and after the PCNL procedure demonstrated the stabilization of corresponding glomerular filtration rate in the treated kidney (48.2 ± 3.7 vs 50.4 ± 5.2 mL/min; P = .22).

Conclusion: When performed by experienced endourologists, PCNL is a safe and effective procedure in infants for the removal of renal calculi.