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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...

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A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
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Published on: September 13, 2022

Percutaneous nephrolithotomy in children: does age matter?

Hasan Serkan Dogan1, Hakan Kilicarslan, Yakup Kordan

  • 1Department of Urology, Faculty of Medicine, Uludag University, 16059, Bursa, Gorukle, Turkey. hasedogan@yahoo.com

World Journal of Urology
|May 19, 2011
PubMed
Summary

Percutaneous nephrolithotomy (PCNL) is safe and effective for younger children, with stone-free rates comparable to older children. Younger patients experienced less stone burden and fewer accesses, with no increased complications.

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Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery

Background:

  • Kidney stones in children present unique challenges.
  • Percutaneous nephrolithotomy (PCNL) is a common treatment for pediatric kidney stones.

Purpose of the Study:

  • To compare the outcomes of PCNL in pediatric patients stratified into two age groups: ≤5 years and >5 years.
  • To evaluate the safety and efficacy of PCNL in younger children compared to older children.

Main Methods:

  • A retrospective analysis of 45 patients (51 renal units) who underwent PCNL between 2006 and 2010.
  • PCNL was performed using a pediatric nephroscope and a 20F Amplatz sheath.
  • Patients were divided into two groups: Group 1 (≤5 years) and Group 2 (>5 years).

Main Results:

  • The overall stone-free rate was 86.2%.
  • Younger children (≤5 years) had a significantly lower stone burden and required fewer accesses.
  • Both age groups showed similar postoperative hospital stays, gender distribution, stone characteristics, and complication rates.

Conclusions:

  • PCNL is a safe and effective treatment for kidney stones in preschool-aged children.
  • Age is not a limiting factor for PCNL, as outcomes are comparable to older children.
  • Complications associated with PCNL in children are typically low-grade and manageable conservatively.