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[Therapeutic approach in urinary tract stones in children]
Insights
Pediatric kidney stones require active treatment in over 50% of cases. This study highlights effective urolithiasis management in children, achieving a 79% stone-free rate with various treatment modalities.
Area of Science:
- Pediatric Urology
- Nephrology
- Medical Imaging
Context:
- Kidney stone disease (urolithiasis) is uncommon in children.
- Spontaneous stone expulsion occurs in only 34-47% of pediatric cases.
- A significant portion of children require active medical or surgical intervention for urinary stones.
Purpose:
- To present the experience and outcomes of urolithiasis treatment in pediatric patients.
- To evaluate different treatment modalities for kidney stones in children.
- To establish the need for standardized diagnosis and treatment protocols in pediatric urolithiasis.
Summary:
- A retrospective review of 69 pediatric patients (≤16 years) treated for urolithiasis between 2000-2013.
- Diagnosis was consistently made via abdominal ultrasound; common presentations included pain.
- Treatments included extracorporeal shock wave lithotripsy and ureteroscopy, resulting in an overall 79% stone-free rate with no observed complications.
Impact:
- Demonstrates the feasibility and success of various minimally invasive treatments for pediatric kidney stones.
- Highlights the importance of specialized care centers for managing pediatric urolithiasis.
- Provides data supporting tailored treatment strategies based on patient age, stone characteristics, and clinical expertise.
Purpose:
Kidney stone disease in children is a rare pathology, with a low incidence in Spain (1/4,500 hospitalized children). The spontaneous expulsion rate is about 34-47% which means that more of 50% of children need active treatment. Paediatric patients forming urinary stones have a high risk of recurrence, therefore, a standard diagnosis and treatment are needed. We present our experience in urolithiasis treatment in children.
Materials And Methods:
We reviewed retrospectively all the patients ≤ 16 years hospitalized in our hospital with urolithiasis diagnosis from 2000 to 2013, citing treatment modality, stone-free rates and complications.
Results:
A total of 69 patients with a mean age of 8,2 years (range 1-16 years) were treated in our hospital during that period. The main clinical presentation was pain (52%). The diagnosis was made by abdominal ultrasounds in all cases. About localization, 21 lithiasis were found in distal urether (UD), 8 in medium urether (UM), 3 in proximal urether (UP) and 13 in renal pelvis (PR). The mean size was 13 mm. 21 (30%) patients had a spontaneous expulsion of the stone, 14 (20%) patients were treated with extracorporeal shock wave lithotripsy and in 22 (32%) patients the elected therapy was ureterosopic stone fragmentation (n = 13) or removal (n = 9). No complications were observed. The overall stone-free rate was 79% (n = 55).
Conclusions:
Kidney stone disease in children is a rare pathology, with its own features about diagnosis and treatment, which requires medical care in a specialized center. The optimal treatment should be considered regarding the age of the patient, localization and size of the stone, as well as the team experience.
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