Urolithiasis

Update on Surgical Management of Pediatric Urolithiasis

“…In a small study of 58 renal units, we assessed the relationship between the stone densities in Hounsfield unit and the results of treatment by ESWL. The outcome showed that a lower HU is associated with better clearance for the same size of stone (5). Similar observations had been documented by others (57).…”

“…In the single stone group of 158 renal units with a mean stone size of 10 ± 2.5 mm, 76% (121 renal units) were cleared in a single session, and 21 units were cleared in a second session, giving an overall clearance rate of 89% in a mean of 1.14 sessions. In the second group of 58 renal units comprising multiple stones having a mean size of 17 ± 5.3 mm, 46% (27 units) were cleared in a single session, 32% (19 units) were cleared in a second session, and 7% (4 units) cleared in a third session, giving an overall clearance rate of 86% in a mean of 1.54 sessions (5).…”

“…The outcome in terms of stone clearance and complication rates is excellent and comparable. Although PL has the advantage of being significantly cheaper as compared to LL, PL can only be used through 6/7.5FG ‘scopes and above, while LL can be used with the small ‘scopes (4.5/6FG), which is an advantage for infants and small children (2, 5, 79, 82, 83).…”

“…Apart from a high prevalence of pediatric urolithiasis in endemic areas (2, 3), there is an increasing incidence all over the world (4). Within the pediatric age group, clinical presentations are varied, and evaluation, including imaging, and management have to be modified depending on whether they are infants, preschool children, or pre- or post-pubertal teenagers (2, 5–7).…”