Related Experiment Video

Updated: Apr 4, 2026

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
03:56

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

Published on: September 13, 2022

3.1K

Medical expulsive treatment in pediatric urolithiasis

Ali Atan1, Melih Balcı2

  • 1Department of Urology, Karabük University Faculty of Medicine, Karabük, Turkey.

Turkish Journal of Urology
|September 2, 2015
PubMed

Insights

Pediatric stone disease, affecting 0.1-5% of children, necessitates effective treatments. Medical expulsive therapy offers a less invasive, cost-effective alternative to surgery for childhood urolithiasis.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Pharmacology

Background:

  • Childhood stone disease (urolithiasis) prevalence ranges from 0.1% to 5%, influenced by environmental, metabolic, anatomical, infectious, and nutritional factors.
  • Established treatments like percutaneous nephrolithotomy, ureterorenoscopy, and extracorporeal shock wave lithotripsy carry risks and costs.
  • Medical expulsive treatment (MET) has emerged as a viable, less invasive alternative for select pediatric urolithiasis cases.

Purpose of the Study:

  • To review the necessity and application of medical expulsive treatment for pediatric stone disease.
  • To guide the selection of appropriate drugs based on stone characteristics and patient factors.
  • To discuss the optimal duration for medical expulsive therapy in childhood urolithiasis.

Main Methods:

  • Review of existing literature on medical expulsive treatments for pediatric urolithiasis.
  • Analysis of various drug classes used in MET, including NSAIDs, antimuscarinics, PDE5 inhibitors, steroids, calcium channel blockers, and alpha blockers.
  • Consideration of factors influencing drug choice: stone location, size, composition, technology, cost, and clinician/parent preferences.

Main Results:

  • Medical expulsive therapy presents a cost-effective and less invasive option compared to surgical interventions for pediatric urolithiasis.
  • Drug selection for MET is multifactorial, requiring careful consideration of stone parameters and patient-specific variables.
  • Evidence supports the efficacy of various pharmacological agents in facilitating stone expulsion in children.

Conclusions:

  • Medical expulsive treatment is a valuable component in the management of childhood urolithiasis, offering an alternative to invasive procedures.
  • Personalized drug selection and treatment duration are crucial for optimizing outcomes in pediatric patients undergoing MET.
  • Further research may refine guidelines for MET in pediatric urolithiasis, enhancing its role in clinical practice.

Keywords:
Pediatricstonetreatment

More Related Videos

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis03:57

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

Published on: July 8, 2025

376

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...
846
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)...
326
Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
5.5K
Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
423
Urinary Tract Calculi IV: Nutrition Therapy and Prevention01:27

Urinary Tract Calculi IV: Nutrition Therapy and Prevention

Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
657
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...
377