Comparison of efficacy and safety between bilateral single-session PCNL and bilateral staged PCNL in preschool children

Caixiang Zhang^1,2,#, Xiaochuan Wang^1,2,#, Youquan Zhao^1,2, Houyu Zhou³, Kahriman Islam^4,5, Jesur Batur^4,5, Jun Li^1,2,*
1 Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
2 Institute of Urology, Beijing Municipal Health Commission, Beijing, China
3 Department of Urology, Aerospace Center Hospital, Beijing, China
4 Department of Urology, First People’s Hospital of Kashgar, Kashgar, China
5 Xinjiang Key Laboratory of Artificial Intelligence Assisted Imaging Diagnosis, Kashgar, China
* Corresponding Author: Jun Li. Email: email
# Caixiang Zhang and Xiaochuan Wang contributed equally to this work

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.083925

Received 16 April 2026; Accepted 29 July 2026; Published online 31 August 2026

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Abstract

Objective: Bilateral kidney stones in preschool children are challenging to manage, and the optimal surgical strategy remains unclear. This study aimed to compare the efficacy and safety of bilateral single-session percutaneous nephrolithotomy (PCNL) and bilateral staged PCNL in preschool children with bilateral kidney stones. Methods: We retrospectively reviewed preschool children aged <7 years with bilateral kidney stones who underwent PCNL at our two centers between June 2014 and June 2025. Patients were divided into a bilateral staged PCNL group and a bilateral single-session PCNL group. Perioperative outcomes, stone-free rate (SFR), and complication rate (CR) were compared, and logistic regression analyses were performed to identify factors associated with SFR and CR. Results: No significant difference in SFR (per renal unit) was observed between the bilateral single-session PCNL group and the bilateral staged PCNL group (87.18% vs. 72.92%, p = 0.232). CR (per person) was also comparable between the two groups (43.59% vs. 33.33%, p = 0.419), and all recorded complications were low-grade and manageable, corresponding to Clavien-Dindo Grades I-II. Multivariable logistic regression analysis showed that bilateral single-session PCNL was independently associated with a higher SFR compared with bilateral staged PCNL (odds ratio [OR]: 11.75; 95% confidence interval [CI]: 1.62–85.15; p = 0.015). Tract size >4.8 Fr was also independently associated with a higher SFR (OR: 5.73; 95% CI: 1.01–32.61; p = 0.049). No evaluated variable was significantly associated with CR. Conclusion: Bilateral single-session PCNL is an effective therapeutic strategy for the management of preschool children with bilateral kidney stones, providing stone-free outcomes and complication rates comparable to those of bilateral staged PCNL.