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LETTER TO EDITOR
Year : 2021  |  Volume : 37  |  Issue : 2  |  Page : 202-203
 

Author reply Re: Chandramohan V, Siddalingaswamy PM, Ramakrishna P, Soundarya G, Manas B, Hemnath A. Retrograde Intrarenal Surgery for renal stones in children <5 years of age. Indian J Urol 2021;37:48-53


Department of Urology, Preeti Urology and Kidney Hospital, Hyderabad, Telangana, India

Date of Submission04-Feb-2021
Date of Decision25-Feb-2021
Date of Acceptance14-Mar-2021
Date of Web Publication1-Apr-2021

Correspondence Address:
P M Siddalingaswamy
Department of Urology, Preeti Urology and Kidney Hospital, Hyderabad, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/iju.IJU_53_21

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How to cite this article:
Chandramohan V, Siddalingaswamy P M, Paidakula R, Ganesan S, Manas B, Anandan H. Author reply Re: Chandramohan V, Siddalingaswamy PM, Ramakrishna P, Soundarya G, Manas B, Hemnath A. Retrograde Intrarenal Surgery for renal stones in children <5 years of age. Indian J Urol 2021;37:48-53. Indian J Urol 2021;37:202-3

How to cite this URL:
Chandramohan V, Siddalingaswamy P M, Paidakula R, Ganesan S, Manas B, Anandan H. Author reply Re: Chandramohan V, Siddalingaswamy PM, Ramakrishna P, Soundarya G, Manas B, Hemnath A. Retrograde Intrarenal Surgery for renal stones in children <5 years of age. Indian J Urol 2021;37:48-53. Indian J Urol [serial online] 2021 [cited 2021 Jul 25];37:202-3. Available from: https://www.indianjurol.com/text.asp?2021/37/2/202/312929


We thank the readers for their interest in our article.[1] We performed intravenous pyelogram (IVP) or computed tomographic (CT) scan before surgery to assess the anatomy of the pelvicalyceal system along with the size of the stone. Ultrasound can delineate stones very well in children. We agree the CT as the gold standard but children are known to have stone recurrence and even low-dose NCCT exposes them to very high cumulative radiation dose. The highly sensitive ultrasound machines pick up stones without any radiation.

Our primary objective was to assess the feasibility of retrograde intra renal surgery (RIRS) in children aged <5 years. We have not analyzed the diethylene triamine pentaacetic acid (DTPA) scan-related outcome in our study. All children underwent urine culture before stenting and also before RIRS. Only those with a negative urine culture underwent RIRS. Retrograde pyelogram (RGP) is done not only for any extravasation or intravasation of contrast but also for any residual stones seen as filling defects. Rigid or flexible ureteroscopy is only to look for ureteric injuries. It is our hospital protocol to do this in all the RIRS cases. Eight children who had fever >38°C without any elevation of total leucocyte count or C reactive protein were managed without change of antibiotics, hence they are included in Clavien grading 1. Only two cases with fever required change of antibiotics.

We thank you for pointing out additional errors and apologize for them. In table 2 of the original manuscript[1], residual stones >2 mm were seen in 14 (23.7%) cases and not 9 (15.3%). In table 1 of the original manuscript[1], left side cases inadvertently included the left side of the bilateral cases too. The isolated left side cases should be read as 33 instead of 38 cases. We also agree with your comment regarding our citation of the study by Ekurt et al.[2] They did report the complications as per the Clavien system. Once again, we apologize for these errors and all these have been corrected in the erratum published for the manuscript.

Financial support and sponsorship: Nil.

Conflicts of interest: There are no conflicts of interest.

 
   References Top

1.
Chandramohan V, Siddalingaswamy PM, Ramakrishna P, Soundarya G, Manas B, Hemnath A. Retrograde intrarenal surgery for renal stones in children<5 years of age. Indian J Urol 2021;37:48-53.  Back to cited text no. 1
  [Full text]  
2.
Erkurt B, Caskurlu T, Atis G, Gurbuz C, Arikan O, Pelit ES, et al. Treatment of renal stones with flexible ureteroscopy in preschool age children. Urolithiasis 2014;42:241-5.  Back to cited text no. 2
    




 

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