title: How does acute urolithiasis present after renal denervation?
abstract: OBJECTIVE
  To present our experience with the acute presentation of urolithiasis after laparoscopic renal denervation and nephropexy for intractable renal pain in the pediatric patient.
  
  
  METHODS
  Five patients aged 8 to 16 years (mean age 11.4 years) with a history of laparoscopic renal denervation presented with acute abdominal symptoms; obstructing urolithiasis was diagnosed.
  
  
  RESULTS
  There were a total of 12 episodes of acute urolithiasis in this cohort. All five patients presented with periumbilical and epigastric discomfort when the stone was on the denervated side. During the episodes, of the five patients, three (60%) also presented with vomiting; four (80%) had at least one episode of gross hematuria; and five (100%) had microscopic hematuria during episodes on the denervated side. None of the patients presented with flank discomfort on the denervated side.
  
  
  CONCLUSIONS
  Stone-related pain in patients undergoing laparoscopic renal denervation and nephropexy is not a typical presentation, and one needs to be wary of vague abdominal pain in this population.
authors.affiliation: Department of Urology, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19107, USA.
authors.forename: Curtis
authors.initials: C
authors.lastname: Ross
authors.forename: Michael C
authors.initials: MC
authors.lastname: Carr
authors.forename: Pasquale
authors.initials: P
authors.lastname: Casale
mesh_terms: D015746:Abdominal Pain / Q000601:surgery*; D000208:Acute Disease; D000293:Adolescent; D002648:Child; D003714:Denervation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000294:innervation*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D052878:Urolithiasis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*