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Urolithiasis in childhood
B H Ozokutan1, M Küçükaydin, Z Gündüz
1Department of Pediatric Surgery, Erciyes University, Faculty of Medicine, 38039 Kayseri, Turkey.
Insights
Pediatric urolithiasis (urinary tract stones) is common in Turkey, with boys affected more than girls. Hypercalciuria is a frequent cause, and open surgery remains the primary treatment for pediatric urinary tract stones.
Area of Science:
- Pediatric Urology
- Nephrology
- Urolithiasis Research
Background:
- Urolithiasis is a significant pediatric urologic issue, particularly in Turkey.
- Improving living standards may correlate with a declining incidence.
- Anatomic anomalies and metabolic disorders are key etiological factors.
Purpose of the Study:
- To review the characteristics of pediatric urinary tract calculi.
- To analyze patient demographics, clinical presentation, etiology, and treatment outcomes.
- To understand the prevalence and types of stones in children.
Main Methods:
- Retrospective review of 85 pediatric patients with urinary tract calculi over 12 years.
- Data collected included age, sex, symptoms, etiology, stone location, treatment, and stone analysis.
- Analysis of patient records for demographic and clinical information.
Main Results:
- The study included 85 children (68 boys, 17 girls), aged 10 months to 16 years.
- Flank pain was the most common symptom; 70 had upper tract, 31 lower tract calculi.
- Hypercalciuria was the most common metabolic disorder; Calcium oxalate/phosphate stones were most frequent.
Conclusions:
- Urolithiasis remains prevalent in Turkish children, though incidence may decrease with improved living standards.
- Metabolic disorders and anatomic anomalies are crucial in pediatric stone disease etiology.
- Open surgery was the predominant treatment, with limited success for endoscopic and spontaneous stone passage.
Abstract:
A retrospective review was performed of the records of 85 children with urinary-tract calculi evaluated and treated during a 12-year period. The study evaluated the patients' age, sex, initial complaints, etiology, relevant pathological factors, stone location, mode of treatment, and stone analysis. There were 68 boys and 17 girls, a ratio of 4:1. Patient age ranged from 10 months to 16 years (average 8.2 years). Flank pain was the most common manifestation. Seventy patients had calculi in the upper urinary tract and 31 in the lower urinary tract; 16 had stones in more than one site and 15 had bilateral stones. Hypercalciuria was the most common metabolic disorder. Most patients underwent open surgical procedures for removal of their calculi; 5 stones were successfully removed endoscopically. In 3 cases, the stones passed spontaneously. Calcium oxalate and calcium phosphate stones were present in 32 cases, struvite in 5, cystine in 2, and uric acid in 1 Urolithiasis is still one of the most common pediatric urologic problems in Turkey, but as living standards improve, the incidence of the disease has tended to decline in recent years. Anatomic anomalies and metabolic disorders are of great importance in the etiology of stone disease.