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Contemporary practice patterns in the treatment of pediatric stone disease

Rachel B Davis1, Nicholas J Farber, Amy Kaplan

  • 1Department of Urology, Rutgers-Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.

The Canadian Journal of Urology
|August 21, 2018
PubMed

Insights

Pediatric urology fellows gain more experience and confidence in treating pediatric urolithiasis (kidney stones) compared to endourology fellows. Endourology programs should increase pediatric stone case exposure.

Area of Science:

  • Pediatric Urology
  • Urology
  • Surgical Education

Background:

  • Pediatric urolithiasis requires specialized knowledge and skills for effective treatment.
  • Fellowship training significantly impacts a urologist's comfort and competence in managing pediatric stone disease.

Purpose of the Study:

  • To compare the fellowship training exposure and comfort levels in managing pediatric urolithiasis between pediatric urology and endourology fellows.
  • To assess the accessibility of pediatric surgical equipment for stone treatment.

Main Methods:

  • A survey was distributed to pediatric urology and Endourological Society fellowship programs.
  • Fellows reported exposure and comfort levels (1-5 scale) for extracorporeal shock wave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PCNL) across pediatric age groups.
  • Data were analyzed comparing pediatric urology versus endourology fellows.

Main Results:

  • Pediatric urology fellows reported significantly greater exposure to SWL, URS, and PCNL in various pediatric age groups compared to endourology fellows.
  • Pediatric urology fellows demonstrated higher comfort levels in performing SWL, URS, and PCNL across most pediatric age ranges.
  • Endourology fellows reported greater discomfort with URS in toddlers and PCNL in infants and school-aged children.

Conclusions:

  • Pediatric urologists receive more comprehensive training and exhibit greater confidence in treating pediatric urolithiasis during fellowship.
  • Endourology fellowship programs could enhance their curriculum by incorporating more hands-on experience with pediatric stone cases.
Abstract

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