Association Between Postoperative Stent Dwell Time and Stone-Free Status Following Pediatric Retrograde Intrarenal Surgery: A Retrospective Cohort Study.

Purpose

To evaluate the association between postoperative stent dwell time and stone-free status following retrograde intrarenal surgery (RIRS) in pediatric patients.

Methods

This retrospective study included pediatric patients who underwent RIRS for renal stones ≤20 mm. Residual stone fragments were assessed by low-dose computed tomography at 3 months postoperatively and defined as either a single fragment >2 mm or the presence of multiple residual fragments regardless of size. Logistic regression analyses were performed to identify factors associated with stone-free status, including postoperative stent dwell time.

Results

A total of 108 pediatric patients were included, with a mean age of 9.8 ± 4.5 years, and 74 patients (68.5%) were male. Residual fragments were observed in 40 patients (37.0%). In univariable logistic regression analysis, stone burden (P < .001), fragmentation time (P < .001), and the presence of multiple stones (P = .022) were associated with residual fragments. In multivariable analysis, stone burden (P = .007) and fragmentation time (P = .003) remained independent predictors of residual fragments, whereas postoperative stent dwell time was not independently associated with stone-free status (P = .381).

Conclusion

No evidence was found to support an association between postoperative stent dwell time and stone-free status following pediatric RIRS. Earlier stent removal may therefore be feasible in uncomplicated pediatric patients without compromising stone-free outcomes. Further large-scale prospective studies are needed to establish clinical recommendations regarding stent duration.