The first experience in retrograde intrarenal surgery for treating calyceal diverticula in children
- Authors: Kuznetsova M.S.1, Kovarskiy S.L.1,2, Menovschikova L.B.1, Zakharov A.I.2, Struianskii K.A.2, Tekotov A.N.1,2, Sklyarova T.A.2, Petrukhina Y.V.1,2, Betanov Z.V.1,2, Pepelyaeva I.M.1,2, Yusifova U.I.1
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Affiliations:
- The Russian National Research Medical University named after N.I. Pirogov
- Filatov N.F. Children's City Hospital
- Issue: Vol 29, No 4 (2025)
- Pages: 234-241
- Section: Original Study Articles
- Submitted: 28.04.2025
- Accepted: 25.07.2025
- Published: 26.08.2025
- URL: https://jps-nmp.ru/jour/article/view/868
- DOI: https://doi.org/10.17816/ps868
- EDN: https://elibrary.ru/QMNVMT
- ID: 868
Cite item
Abstract
BACKGROUND: A calyceal diverticulum is quite a rare pathology in children. It also poses diagnostic challenges for physicians. The incidence of calyceal diverticula ranges from 3.3 to 4 cases per 1000 children. The gold standard for its diagnostics is computed tomography with intravenous contrast. All diverticula with dimensions exceeding 2.5 cm or more are subject to surgical treatment due to the risk of developing urinary tract infection, pain and possible stone formation. A modern and promising management technique in such patients is retrograde intrarenal surgery.
The article presents the first Russian experience of application of retrograde intrarenal surgery for calyceal diverticula in children.
AIM: To assess the effectiveness of a new minimally invasive method of retrograde intrarenal surgery for treating patients with calyceal diverticula.
METHODS: The authors present their experience on application of retrograde intrarenal surgery for treating calyceal diverticula in 15 patients aged from 6 to 17 years who were admitted to the Department of Urology in N.F. Filatov State Clinical Hospital in Moscow during 2022–2024. All patients had a single diverticulum, and its size was ≥2.5 cm. In 14 children, diverticula were located in the small renal cup, and only in one child it was in the large cup. Preoperative examination included ultrasound and computed tomography with intravenous contrast to assess the communicative function with the renal collector system. Concrements in the diverticular cavity were seen in 6 patients. Surgery was done under endotracheal anesthesia.
RESULTS: All patients were discharged on the third postoperative day with satisfactory urine and blood test findings and without pain. The children were repeatedly hospitalized in 4 weeks so as to remove the stent and to assess the calyceal diverticulum size: in 9 cases—decreased size of the cystic cavity and no complaints; in 6 cases—repeated surgical intervention, probably due to the insufficient size of artificially created fistula at the stages of technique mastering; after the size of cystic cavity got smaller.
CONCLUSION: Retrograde intrarenal surgery is a minimally invasive, promising and effective technique for treating cystic kidney malformations which is being actively implemented by urologists in their practice.
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About the authors
Maria S. Kuznetsova
The Russian National Research Medical University named after N.I. Pirogov
Author for correspondence.
Email: kuznetsovamasha-98@ya.ru
ORCID iD: 0009-0003-7162-294X
SPIN-code: 6045-2879
Россия, 1 Ostrovityanova st, bldg. 6, Moscow, 117513
Semen L. Kovarskiy
The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children's City Hospital
Email: sim3150@gmail.ru
ORCID iD: 0000-0001-6310-7110
SPIN-code: 9308-5014
MD, Dr. Sci. (Medicine), Professor
Россия, Moscow; MoscowLudmila Borisovna Menovschikova
The Russian National Research Medical University named after N.I. Pirogov
Email: ludmilam-2205@yandex.ru
ORCID iD: 0000-0002-0780-9254
MD, Dr. Sci. (Medicine), Professor
Россия, MoscowAndrey I. Zakharov
Filatov N.F. Children's City Hospital
Email: zaharov@pedurology.ru
ORCID iD: 0000-0002-8415-4968
SPIN-code: 8774-5827
MD, Cand. Sci. (Medicine)
Россия, MoscowKirill A. Struianskii
Filatov N.F. Children's City Hospital
Email: kirill-str89@mail.ru
ORCID iD: 0000-0002-1947-1035
SPIN-code: 1896-9823
MD, Cand. Sci. (Medicine)
Россия, MoscowAleksey N. Tekotov
The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children's City Hospital
Email: altekotov@yandex.ru
ORCID iD: 0000-0001-9574-7462
MD, Cand. Sci. (Medicine), Assistant Professor
Россия, Moscow; MoscowTatyana A. Sklyarova
Filatov N.F. Children's City Hospital
Email: info@pedurology.ru
ORCID iD: 0000-0001-8034-6287
SPIN-code: 3220-9190
MD, Cand. Sci. (Medicine)
Россия, MoscowYulia V. Petrukhina
The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children's City Hospital
Email: petrukhina-j@mail.ru
SPIN-code: 7949-0670
MD, Cand. Sci. (Medicine)
Россия, Moscow; MoscowZilim V. Betanov
The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children's City Hospital
Email: betanov@pedurology.ru
MD, Cand. Sci. (Medicine)
Россия, Moscow; MoscowIrina M. Pepelyaeva
The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children's City Hospital
Email: irina_pepelyaeva@bk.ru
ORCID iD: 0000-0002-9397-5709
SPIN-code: 9612-6850
Россия, Moscow; Moscow
Ulviya I. Yusifova
The Russian National Research Medical University named after N.I. Pirogov
Email: u.yusifova.u@mail.ru
ORCID iD: 0000-0001-5032-5741
SPIN-code: 8276-6249
Россия, Moscow
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