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Urethral calculi in children
1Department of Pediatric Surgery, Ataturk University, Faculty of Medicine, Erzurum, Turkey.
Insights
Pediatric urethral calculi presentation and treatment vary by stone location. Posterior urethral stones caused continuous dribbling, while anterior stones led to acute urinary retention in boys.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- Urethral calculi in children present unique diagnostic and management challenges.
- Understanding the factors influencing clinical presentation and treatment is crucial for effective pediatric urological care.
Purpose of the Study:
- To retrospectively evaluate factors influencing the clinical picture and treatment of urethral calculi in pediatric patients.
- To correlate the localization of urethral calculi with clinical symptoms and required interventions.
Main Methods:
- Retrospective analysis of 60 male pediatric patients diagnosed with urethral calculi.
- Evaluation of clinical presentation, stone location (posterior, bulbous, penile, external urethral meatus), and treatment modalities.
Main Results:
- Pain in the penis and self-retraction were common symptoms.
- Posterior urethral calculi were associated with continuous urinary dribbling; anterior calculi with acute urinary retention.
- Calculi were located in the posterior urethra (10), bulbous urethra (13), penile urethra (20), and external urethral meatus (17).
- Retrograde manipulation into the bladder was used for posterior and some bulbous calculi.
- External urethral meatus extraction was performed for 42 calculi.
- Urethrotomy and urethrocutaneous fistula were required for complex cases.
Conclusions:
- The clinical presentation and treatment of pediatric urethral calculi are significantly influenced by stone localization.
- Stone shape and diameter are key determinants of calculus localization and subsequent management strategies.
Abstract:
Sixty patients diagnosed to have urethral calculi in Diyarbakir State Hospital Department of Pediatric Surgery were evaluated retrospectively to determine factors influencing the clinical picture and treatment. All the patients were boys. Pain in the penis and retracting of the penis by the patient himself were most common symptoms. The patients with posterior urethral calculi had continuous urinary dribbling, and those with anterior urethral calculi had acute urinary retention. At the time of initial admittance, the calculi were posterior urethral in 10 cases, bulbous in 13, penile in 20, and external urethral meatal in 17. The 10 calculi located in the posterior urethra and four located in the bulbous urethra were manipulated retrogradely into the bladder. Forty-two calculi were extracted through the external urethral meatus. However, a calculus required urethrotomy, and other calculi required extraction trough a urethracutaneous fistula. The mode of clinical presentation and treatment in children with urinary calculi depends on localization. Localization is determined by the shape and diameter of the calculi.