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[Urinary lithiasis in the child (author's transl)]
Insights
Urinary lithiasis in children, predominantly affecting boys aged 4-6, often presents as kidney stones. Complete surgical treatment is highly effective, with 70% of patients remaining recurrence-free.
Area of Science:
- Pediatric Urology
- Nephrology
- Pediatric Surgery
Context:
- Urinary lithiasis in children is a significant health concern.
- This study analyzes a cohort of 130 pediatric patients with urinary stones.
- The research focuses on epidemiological, etiological, and therapeutic aspects.
Purpose:
- To investigate the characteristics and outcomes of urinary lithiasis in a pediatric population.
- To evaluate the effectiveness of different treatment modalities, particularly surgery.
- To identify risk factors and common presentations of pediatric urinary stones.
Summary:
- The study involved 130 children, with a higher incidence in boys aged 4-6 years.
- Reno-ureteric lithiasis was more common than vesico-urethral, with pyelocalyceal stones predominating.
- Key symptoms included hematuria and abdominal pain; causes were often idiopathic or secondary to obstruction/infection.
- Surgical intervention was the primary treatment, yielding a low recurrence rate of 70%.
Impact:
- Highlights the efficacy of surgical management for pediatric urinary lithiasis.
- Provides insights into the prevalence and contributing factors of childhood kidney stones.
- Emphasizes the importance of complete surgical treatment for minimizing recurrences.
Abstract:
The authors report a series of 130 children suffering from urinary lithiasis (essentially between the age of 4 to 6 years) and particularly in boys (2.5 to 1). There were 108 cases of reno-ureteric lithiasis as against 23 vesico-urethral. In 69 cases, pyelocalyceal lithiasis predominated. Thirty per cent of the children had bilateral lithiasis, and 19% of all cases of lithiasis were staghorn calculi. Presenting symptoms : haematuria, diffuse abdominal pain, anuria (6 cases), complete urinary retention (5 cases). Study of these cases failed to indicate whether obstruction of the upper urinary tract (14%) or infection (27%) was the cause or the effect of the lithiasis. Particularly notable were 8 cases of cystinuria (6%), 1 of glycinuria, 1 of hyperoxaluria and 7 of hypercalciuria. At least in Spain, lithiasis in children would appear to be essentially idiopathic. However, 40% of these cases of lithiasis were secondary to obstruction of the excretory tract and/or urinary infection. All types of entero-uroplasty were lithogenic (6 cases). 32% of the children had a proteus infection. Treatment : 14 children were treated medically as against 125 surgically. 70% are free of any recurrence. 7% have a residual lithiasis. The rarity of recurrences and the quality of the results obtained indicate that complete surgical treatment represents the essential feature of the treatment of urinary lithiasis in children.