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Urolithiasis in children
1Department of Surgery (Urology), Cornell University Medical College, New York, New York, USA.
Urology
|February 18, 2011
Summary
Pediatric urinary tract calculi are uncommon. Thorough evaluation reveals underlying causes in most children, allowing for targeted treatment beyond standard stone management.
Area of Science:
- Pediatric Urology
- Nephrology
- Metabolic Disorders
Background:
- Urinary tract calculi in children are rare, affecting 1-4 per 1000 pediatric admissions in the US.
- Primary and secondary calculi differ in cause, composition, and prognosis, requiring separate consideration.
- Literature suggests 60% of pediatric stones are idiopathic, similar to adults.
Purpose of the Study:
- To investigate the incidence and causes of urinary tract calculi in children.
- To determine the yield of thorough urologic and metabolic evaluations in identifying underlying abnormalities.
- To compare findings with existing literature regarding idiopathic stones.
Main Methods:
- Retrospective review of twenty-five primary and twenty-five secondary pediatric calculi cases.
- Comprehensive urologic and metabolic evaluations for all identified cases.
- Comparison of findings with US and UK literature.
Main Results:
- Contrary to literature, only six out of fifty pediatric calculi were truly idiopathic in this non-endemic area.
- Thorough evaluations yielded a significant number of metabolic or structural abnormalities.
- This suggests a higher treatable cause rate than previously reported.
Conclusions:
- Pediatric urinary tract calculi often have identifiable underlying causes.
- Comprehensive urologic and metabolic assessment is crucial for diagnosis.
- Treatment should address both the stones and their root causes for improved outcomes.
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