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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...
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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Paediatric percutaneous nephrolithotomy: single-centre 10-year experience.

Anand Bhageria1, Brusabhanu Nayak, Amlesh Seth

  • 1Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

Journal of Pediatric Urology
|March 19, 2013
PubMed
Summary
This summary is machine-generated.

Percutaneous nephrolithotomy (PCNL) is a safe and effective treatment for pediatric kidney stones, achieving high stone-free rates. While supracostal access had more complications, overall outcomes were excellent.

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Area of Science:

  • Pediatric Urology
  • Nephrolithiasis Management
  • Minimally Invasive Surgery

Background:

  • Percutaneous nephrolithotomy (PCNL) is a key treatment for large pediatric kidney stones.
  • Concerns exist regarding potential complications in children undergoing PCNL.

Purpose of the Study:

  • To evaluate the safety and efficacy of PCNL in pediatric patients.
  • To analyze outcomes and complications over a decade of experience.
  • To compare supracostal versus infracostal access routes.

Main Methods:

  • Retrospective review of pediatric PCNL cases over 10 years.
  • Standard prone position PCNL under fluoroscopic guidance.
  • Complications graded using the modified Clavien system.

Main Results:

  • 95 children underwent PCNL, with 94% achieving stone clearance after secondary procedures.
  • Supracostal access (32 cases) had higher complication rates (50%) including fever, sepsis, and hydrothorax.
  • Infracostal access (63 cases) had a lower complication rate (10%) with fever and perinephric collection.

Conclusions:

  • PCNL is a safe and effective procedure for pediatric renal calculi.
  • Excellent stone clearance can be achieved with minimal interventions.