Objective: This study compares the clinical outcomes of mini-percutaneous nephrolithotomy (m-PNL) and retrograde intrarenal surgery (RIRS) in managing 10–20 mm renal stones in pediatric patients. The primary objective is to evaluate stone-free rates (SFRs), operative parameters, and complications to provide insights into optimal treatment strategies for pediatric nephrolithiasis.
Materials and
Methods: A retrospective analysis of 39 pediatric patients under 18 years of age who underwent m-PNL (Group 1) or RIRS (Group 2) for renal stones between 10 and 20 mm from January 2016 to March 2024 was conducted. Patients were assessed for demographic data, operative time, hospitalization duration, fluoroscopy time, hemoglobin reduction, SFRs, and complications. Statistical analyses were performed to compare the two groups.

Results: The mean operative time, hospitalization duration, and fluoroscopy time were significantly shorter in the RIRS group (p<0.001), with lower post-operative hemoglobin reduction compared to the m-PNL group. At the 1-month follow-up, SFRs were comparable between groups (m-PNL: 95.2%, RIRS: 94.9%, p=0.710). Minor complications were observed in both groups without significant differences. RIRS demonstrated advantages in hospital stay and reduced radiation exposure, while m-PNL required fewer anesthesia sessions.

Conclusion: Both m-PNL and RIRS are effective and safe for treating pediatric kidney stones. While RIRS offers shorter operative and hospitalization times with reduced hemoglobin loss, m-PNL avoids the need for routine double-J stenting and additional anesthesia. Treatment choice should be individualized, considering clinical factors and family preferences, to optimize outcomes in pediatric nephrolithiasis management.