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Surgical treatment methods of urolithiasis in the pediatric population

Joanna Samotyjek1, Beata Jurkiewicz1, Andrzej Krupa1

  • 1Pediatric Surgery and Urology Clinic CMKP in Dziekanów Leśny, Poland.

Developmental Period Medicine
|April 12, 2018
PubMed

Insights

Pediatric urolithiasis, or kidney stones in children, is a growing concern. While most stones pass naturally, various surgical treatments like extracorporeal shockwave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCNL) exist for complex cases.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Surgical Interventions

Background:

  • Pediatric urolithiasis incidence has risen over the last 25 years.
  • The average age for pediatric stone patients is 7-8 years, with recurrence rates between 24%-50%.
  • Over 80% of pediatric stones pass spontaneously, but others require intervention.

Purpose of the Study:

  • To review the diagnostic and therapeutic challenges of pediatric urolithiasis.
  • To outline the available surgical treatment options for pediatric kidney stones.
  • To discuss the indications for different surgical procedures in children.

Main Methods:

  • Review of current surgical techniques for pediatric urolithiasis.
  • Comparison of indications and applications for extracorporeal shockwave lithotripsy (ESWL), ureterolithotripsy (URSL), retrograde intrarenal surgery (RIRS), percutaneous nephrolithotomy (PCNL), and open/laparoscopic surgery.
  • Analysis of factors influencing treatment choice.

Main Results:

  • Surgical procedures for pediatric urolithiasis are similar to those in adults.
  • ESWL is indicated for upper urinary tract stones ≤20 mm.
  • PCNL is recommended for larger or harder stones (≥1.0-1.5 cm) in specific kidney locations; URSL/RIRS for ureteral and renal stones; open surgery for complex cases with anomalies or when other methods fail.

Conclusions:

  • Treatment selection for pediatric urolithiasis depends on stone characteristics, location, and patient factors.
  • Minimally invasive techniques like ESWL, PCNL, URSL, and RIRS are primary options.
  • The goal is an effective, safe procedure ensuring complete stone clearance in a single intervention.

Keywords:
ESWLPCNLRIRSURSLchildrenurolithiasis

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