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Urolithiasis in childhood: surgery and lithotripsy
B Zupancić1, A Antabak, I Bradić
1University Department of Surgery, University Hospital Centre and School of Medicine, Zareb, Croatia.
Summary
Extracorporeal shock-wave lithotripsy (ESWL) is effective for treating pediatric urolithiasis, particularly for calculi not caused by congenital malformations or prior surgeries. Open surgery remains the preferred method for complex cases.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Interventions
Background:
- Urolithiasis in children presents diverse etiologies, including congenital anomalies, recurrent infections, and metabolic disorders.
- Management strategies for pediatric kidney stones have evolved with technological advancements.
Purpose of the Study:
- To analyze the outcomes of various interventions for pediatric urolithiasis over an 11-year period.
- To compare the efficacy of extracorporeal shock-wave lithotripsy (ESWL) versus open surgery for pediatric kidney stones.
Main Methods:
- Retrospective review of 174 interventions in 160 children with urolithiasis (1982-1993).
- Categorization of stone causes: congenital malformations, UTIs, previous operations, hypercalciuria, and idiopathic.
- Comparison of stone removal methods: open surgery, ESWL, and endoscopic extraction.
Main Results:
- 129 calculi removed by surgery, 47 by ESWL, and 18 by endoscopic extraction.
- ESWL became the preferred method for non-congenital, non-postoperative stones after 1988.
- No complications reported for ESWL or open surgery.
Conclusions:
- Open surgery remains essential for calculi associated with congenital malformations or postoperative conditions.
- ESWL is a safe and effective alternative for other pediatric urolithiasis cases.
- Treatment choice depends on the underlying etiology of the kidney stones.