Related Experiment Videos
A review of pediatric cases of urinary tract calculi
1Department of Surgery, Princess Margaret Hospital for Children, Perth, Australia.
Insights
This study reviewed 93 children with urinary tract calculi, finding differences in presentation between Aboriginal and non-Aboriginal children. Open surgery was common, with percutaneous nephrolithotomy emerging as a future trend.
Area of Science:
- Pediatric Urology
- Nephrolithiasis Research
- Public Health Disparities
Background:
- Urinary tract calculi in children present diagnostic and management challenges.
- Understanding demographic and clinical differences in pediatric stone disease is crucial for targeted interventions.
- Previous research has not fully elucidated the distinct characteristics of urinary tract calculi in different pediatric populations.
Purpose of the Study:
- To compare the clinical presentation, demographics, and treatment outcomes of urinary tract calculi in Aboriginal and non-Aboriginal children.
- To identify trends in surgical management and evaluate the success rates of different interventions.
- To assess the prevalence and location of urinary tract calculi in a pediatric cohort over a decade.
Main Methods:
- Retrospective review of medical records for 93 children treated for urinary tract calculi between 1983 and 1992.
- Categorization of patients into Aboriginal and non-Aboriginal groups based on origin and age at presentation.
- Analysis of calculi location, presenting symptoms, surgical procedures, and treatment success rates.
Main Results:
- Two distinct groups were identified: 63 Aboriginal children (younger, presenting with urinary tract infections and failure to thrive) and 30 non-Aboriginal children (older, presenting with abdominal/flank pain).
- Upper urinary tract calculi were found in 91.4% of patients, with 8.6% having bladder calculi.
- Open surgical procedures were the primary treatment, achieving an 86% success rate; percutaneous nephrolithotomy showed promise for selected cases.
Conclusions:
- Significant differences exist in the presentation and demographics of urinary tract calculi between Aboriginal and non-Aboriginal children.
- Open surgery remains a common and effective treatment for pediatric urinary tract calculi, though minimally invasive techniques are gaining traction.
- Percutaneous nephrolithotomy represents a promising future approach for managing renal pelvic calculi in children.
Abstract:
A retrospective review was performed of the records of 93 children with urinary tract calculi treated during a 10-year period (1983 to 1992). Two distinct groups of patients were identified. One group comprised 63 Aboriginal children, mainly from the northern region of Western Australia, who presented at a young age (average, 2.8 years) with urinary tract infections and failure to thrive. The other group comprised of 30 non-Aboriginal children, mainly from the metropolitan region, who presented at an older age (average, 6.7 years) with abdominal and flank pain. Calculi were located in the upper urinary tract in 85 children (91.4%) and in the bladder in eight (8.6%). Most patients underwent open surgical procedures for removal of their calculi, and the overall success rate was 86%. In recent years, percutaneous nephrolithotomy has been used successfully in selected patients with renal pelvic calculi. This method seems to be the trend for the future.