Management of stones in childhood.
OBJECTIVE
The purpose of this review was to report on the latest world literature relating to paediatric stone disease. Inevitably, because of the small numbers, the literature is limited and consists mainly of case series from individual centres. There is also a wide variation in criteria and techniques, making direct comparison limited.


RESULTS
Changes in the incidence of stone disease are becoming more apparent particularly in female patients. Metabolic abnormalities can be identified in the majority of children with stones, and even in the absence of obvious physical stone, if detected warrant further follow-up. Data supporting the safety and efficacy of treatments for stones in children is improving constantly, but choosing the best option may be difficult on current evidence. Better long-term follow-up is still needed regarding adverse effects of treatment.


CONCLUSIONS
A high index of suspicion is required for the diagnosis of stone disease in children, especially in the very young. After exclusion of anatomical abnormalities, metabolic evaluation is important in management and prevention of recurrence. Modalities for treatment are expanding all the time, but due to overall small numbers, and variations in the availability of technology, consensus views about treatment are difficult to agree.
Thomas
Ben G
BG
Consultant Urological Surgeon Scottish Lithotripter Centre, Western General Hospital, Crewe Road, Edinburgh, UK. bthomas2@nhs.net
D002648:Child; D006801:Humans; D018666:Ureteroscopy; D014545:Urinary Calculi / Q000175:diagnosis* / Q000628:therapy*