Articles in Press-Grand Journal of Urology

Articles in Press

Original Article

Pediatric Urology, Online First: 18 December 2025

Grand J Urol 2025; DOI: 10.5505/GJU.2026.59672

Effect and Results of Retrograde Intrarenal Surgery in Pediatric Patients According to Stone Size and Location

Mehmet Özay Özgür, İbrahim Halil Baloğlu, Gökçe Karlı, Kaya Horasanlı

Objective: We aimed to evaluate the effects and results of RIRS according to the location and size of kidney stones in the pediatric population. Materials and Methods: A total of 32 pediatric patients with upper urinary tract stones with 40 renal units were investigated in terms of stone size and location. Stone location, gender, stone size, stone Hounsfield unit, preoperative stenting, access sheath size, complication, length of hospital stay, and stone-free rates were retrospectively analyzed . Patients were divided into two groups. The first group patients who had stones smaller than 2cm, and the second group who had stones larger than 2 cm. Results: The mean age of the patients in Group 1 was determined as 10,8 (4-17) years, and the mean age of Group 2 was determined as 15,1 (10-17) years. The age difference was statistically significant (p: 0,003). There was no statistically significant difference in gender distribution (p: 0,289). The average stone size of Group 1 was measured as 12,6 mm (11-17), and the Group 2 stone size was measured as 25,2 mm (20-43) on average. In terms of operation times, the average operation time in Group 1 was 48 (30-70) minutes, and the average operation time in Group 2 was 65 (40-95) minutes, and a statistically significant difference was observed (p: 0.015). In the first group, the stone-free rate in a single session was 76.3%, and in the second group, the stone-free rate in a single session was 62%. There was no statistically significant difference between the groups in terms of stone-free rates (p: 0,295). Conclusion: RIRS is a method that can be used safely and effectively in pediatric patients with kidney stones smaller than 2 cm, with high stone-free rates. Although; the stone-free rate was lower in stones larger than 2 cm compared to those smaller than 2 cm, this difference was not statistically significant.

Pediatric Urology, Online First: 27 October 2025

Grand J Urol 2025; DOI: 10.5505/GJU.2026.00922

Testicular Microlithiasis in Pediatric Patients

Onursal Varlıklı, Mustafa Alper Akay, Necla Gürbüz Sarıkaş, Yonca Anık

Objective: Testicular microlithiasis (TM) is characterized by parenchymal calcifications, identified as hyperechoic, shadowless foci measuring between 1 and 3 mm in diameter within the testicular parenchyma. This condition is typically detected incidentally through ultrasonography in rare inguinal-scrotal disorders in pediatric patients. TM has been linked to various pathological conditions of the testis, notably an elevated risk of tumor development. A retrospective review of TM cases was conducted to assess clinical features and long-term follow-up outcomes. Materials and Methods: This retrospective analysis was conducted over a 12-year period involving children diagnosed with TM through scrotal Doppler ultrasonography at our outpatient clinic. Medical records were examined to evaluate patient age, indications for ultrasound, associations with inguinal-scrotal pathologies, and follow-up findings. Results: In this study, fifty-six patients aged between 2 and 17 years (median age of 9 years) were included. Bilateral TM was observed in all cases, except for 15 patients who exhibited unilateral foci. Among the participants, 27 patients (48.2%) presented with concomitant inguinal-scrotal pathology, while 3 patients (5.3%) had systemic disease. Notably, microlithiasis and Leydig cell tumors were identified in one patient who underwent ultrasonography due to testicular pain. Conclusion: TM is predominantly bilateral and of the classic type, with testicular pain potentially indicating its presence. Ultrasonography is generally adequate for both the diagnosis and monitoring of testicular microlithiasis. An association with testicular tumors is noted, particularly within the pediatric population. Given that both benign and malignant lesions are linked to TM, studies involving larger populations and extended follow-up periods are warranted.

Case Report

Urologic Oncology, Online First: 08 December 2025

Grand J Urol 2025; DOI: 10.5505/GJU.2026.35119

Angioleiomyoma of the Kidney: Differentiating the Rare Benign Histology from the More Sinister Malignant Tumors of Kidney- A Case Report

Parth Shah, Siddharth Yadav, Harshdeep Singh, Aravind T K, Sneha Sangwan

Renal angioleiomyoma is an exceptionally rare benign mesenchymal tumor, with fewer than five cases documented in the literature. Histologically, it is composed of proliferating smooth muscle cells intersected by branching, slit-like vascular channels and typically lacks significant epithelial components. Despite its benign nature, its morphological overlap with certain renal malignancies presents a diagnostic challenge. Notably, renal cell carcinoma with angioleiomyomalike stroma, a recently recognized variant of renal cell carcinoma, demonstrates a histologically and immunohistochemically similar stromal component. Although it generally exhibits a more indolent clinical course, there have been reports of lymph node involvement, underscoring its malignant potential. In this report, we present a case of renal angioleiomyoma and discuss the importance of distinguishing it from its malignant counterpart. Histopathological evaluation, supplemented by immunohistochemistry, plays a vital role in achieving a definitive diagnosis. Accurate differentiation is crucial to avoid overtreatment and to ensure appropriate clinical management. The overall prognosis is excellent, reflecting the inherent benign nature of renal angioleiomyoma. No routine long-term surveillance is required once a diagnosis is accurately confirmed. However, pathological overlap with renal cell carcinoma with angioleiomyoma-like stroma may necessitate selective follow-up in cases of diagnostic ambiguity. Improved awareness of renal angioleiomyoma helps ensure correct diagnosis and prevents confusion with malignant or other benign mesenchymal tumors that involve the kidney.