Therapeutic possibilities for urolithiasis in childhood

Abstract Objectives We present our case studies on pediatric urolithiasis, the techniques employed in its treatment and its results. Material and methods A retrospective study of pediatric urolithiasis of the upper urinary tract (UUT) treated at our center between 2003 and 2014. We recorded demographic, clinical, diagnostic and therapeutic data and the complications. The therapeutic plan was recorded as isolated (extracorporeal lithotripsy, ureterorenoscopy, nephrolithotomy or surgery) or combined therapy. Results We examined 41 renoureteral units in 32 patients. The median age was 5 years (range, 11 months–14 years). The mean size was 12.9 cm (±7.3 mm). The locations were as follows: 23 (56%) in the renal pelvis (staghorn in 15 cases), 10 (24) in lower calyx and 8 (20%) in the ureter. We performed 80 procedures, with no differences in the age groups, which resulted in 12 complications (15%) but no septic condition secondary to lithotripsy. Stone removal from the ureter had a 100% success rate with the ureterorenoscopy. The overall cure rate was 90%. Conclusion The pediatric urolithiasis approach offers multiple alternatives. It is therefore important to tailor the procedure according to the size, location and composition of the stone. In our center, the use of pediatric extracorporeal shock wave lithotripsy is safe. Ureterorenoscopy, semirigid or flexible, provides excellent results in ureters. Percutaneous nephrolithotomy with minimal access can be performed on small children and nursing infants.