2-Year-Old boy Successfully Treated for Kidney Stones at Asian Institute of Nephrology and Urology Chennai

• 6 mm and 8 mm stones in the right kidney, 12 mm in the left kidney
• A rare condition affecting only (65/100,000) children
• Urine blocked due to large stones
• Stones removed in a single stage using Simultaneous Bilateral Endoscopic Surgery (PCNL + RIRS) by Chennai AINU doctors

Chennai, 17th Oct 2024: Pediatric organs, especially in toddlers as young as two years old, are incredibly delicate and small. It is highly uncommon for toddlers of this age to develop kidney stones, especially stones large enough to block urine flow, causing kidney failure. In a rare case, a two-year-old boy presented with two stones in each kidney, which obstructed urination, leading to temporary kidney failure.

Talking about the initial situation, Dr. Arun Kumar Balakrishnan, Chief Consultant Urologist, Asian Institute of Nephrology and Urology Chennai, said, "Initially, the toddler was brought to the hospital by the father from a far-away town, who read about us in a newspaper. The toddler’s inability to urinate, inconsolable cry and fever alarmed the family, and they took the child to a local hospital in their home-town. After thorough tests, the toddler was found to be on the verge of kidney failure and was in imminent risk of sepsis. Promptly stents were inserted to stabilize kidney function. The local hospital offered only open procedure owing to the small size of the patient and large multiple kidney stones. The parents were worried about open surgery for a small child and approached us for minimally invasive methods. The left kidney contained stones measuring 12 mm, while the right kidney had stones of 6 mm and 8 mm.”

"Treating children is inherently more complex and challenging than treating adults. In this 2-year-old boy, the difficulties began at diagnosis, as young children cannot clearly express their symptoms. The stones were removed through PCNL (percutaneous nephrolithotomy) and RIRS of opposite kidney, simultaneous bilateral endoscopic surgery (SBES), both performed in the same setting and complete clearance of stones were achieved. Following the removal, we removed the stents after one month. In children, there is a higher likelihood of stones recurring compared to adults, so ongoing monitoring and medication may be necessary. It is extremely rare for such young children to develop kidney stones, let alone undergo successful surgery at this age. The state-of-the-art facilities and experienced specialists at Chennai AINU Hospital have made this achievement possible." Dr. Mathisekaran Thangarasu added.

While explaining about SBES, PCNL procedures in pediatric urology, Dr. Venkatsubramanian, Executive Director and Senior Consultant Urologist said, “Simultaneous Bilateral Endoscopic Surgery (SBES) requires lesser anesthesia time and shorter operative time, which reduces the possibility of adverse events as well as the cost of treatment and time spent in the hospital. It is a new technique for the treatment of bilateral kidney stones that involves two surgeons operating in tandem to complete the procedure in a much shorter duration. In this case, for the 12 mm left kidney stone, a mini-PCNL (percutaneous nephrolithotomy) was performed, where a small flank puncture allowed access to break and remove the stone. For the right kidney's 6 mm and 8 mm stones, Retrograde Intrarenal Surgery (RIRS) was done, via the ureter to reach and treat the stones without skin puncture.”