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Paediatric urolithiasis in Greece
P A Androulakakis1, V Michael, S Polychronopoulou
1Department of Paediatric Urology, Aghia Sophia Children's Hospital, Athens, Greece.
Insights
This study analyzed 44 pediatric patients with urinary calculi, finding metabolic disorders and Proteus infections as common causes. Surgical outcomes were positive, with low recurrence rates after thorough evaluation and follow-up.
Area of Science:
- Pediatric Urology
- Nephrolithiasis Research
Background:
- Childhood urolithiasis presents unique challenges in diagnosis and management.
- Identifying associated metabolic disorders and infections is crucial for effective treatment.
Purpose of the Study:
- To evaluate surgical outcomes for pediatric urinary calculi.
- To identify risk factors and recurrence patterns in childhood urolithiasis.
Main Methods:
- Retrospective analysis of 44 pediatric patients undergoing surgery for urinary calculi between 1982 and 1989.
- Assessment of stone characteristics, associated conditions, surgical procedures, and follow-up data.
Main Results:
- Metabolic disorders (25 patients) and Proteus urinary infection (15 patients) were the most frequent associated factors.
- Open surgery was performed in 51 of 55 stones, achieving complete clearance in 29 of 36 kidneys.
- Low recurrence rate (2 patients) observed during a mean 6.2-year follow-up for residual fragments.
Conclusions:
- Comprehensive metabolic investigation and surgical expertise are vital for managing pediatric urolithiasis.
- Prolonged post-operative follow-up is essential for effective long-term management and monitoring recurrence.
Abstract:
A group of 44 patients, aged from 10 months to 14 years, underwent surgery for urinary calculi over a 7-year period (1982-1989). Eleven patients had bilateral or multiple calculi (total number of stones = 55, 20 of which were staghorn). Metabolic disorders (n = 25) and Proteus urinary infection (n = 15) were the 2 factors most often associated with lithiasis. Of the 55 stones, 51 were removed by open surgery. Complete stone clearance was achieved in 29 of 36 kidneys. Follow-up periods in the remaining 7 renal units (with small residual fragments) ranged from 3.5 to 7.5 years (mean 6.2) and revealed stone recurrence in only 2 patients. Evaluation of childhood urolithiasis should include thorough metabolic investigation and sound surgical judgment; effective management requires prolonged post-operative follow-up.