title: Bladder stones in Afghan children.
abstract: OBJECTIVE
  Military surgeons have been providing humanitarian care in Afghanistan since 2002. There are scant published reports on the details of that care. We report here the experience of deployed U.S. Army general surgeons in the management of an endemic problem, bladder stones in Afghan children.
  
  
  METHODS
  A retrospective review was performed of pediatric patients presenting to an International Security Assistance Force humanitarian clinic over a 12-month period from October 2010 to November 2011. Symptoms at presentation, diagnostic modalities, and treatment provided were analyzed. The general surgeons of the 126th Forward Surgical Team (FST) provided surgical consultations for this military humanitarian clinic on a remote base in western Afghanistan.
  
  
  RESULTS
  Eight male pediatric patients of an average age of 4 years presented with dysuria and underwent further evaluation. In five patients, the use of a portable ultrasound machine led to the diagnosis of bladder stones. Three other patients presented with ultrasound exams from an Afghan clinic. Four patients underwent surgical removal of their bladder stones by the FST and 4 four patients, including one with a recurrent bladder stone, were referred to a distant Afghan Regional Hospital. No short-term complications occurred in the five patients available for follow-up.
  
  
  CONCLUSIONS
  Military surgeons providing humanitarian care in rural areas of Afghanistan, and humanitarian surgeons serving in endemic areas, can expect to encounter multiple cases of bladder stones in pediatric patients. Dysuria is a typical presenting symptom. The FST has the resources to diagnose and treat this disorder. If accessible, Afghan regional hospitals can provide curative surgery.
authors.affiliation: Department of Surgery, Fort Belvoir Community Hospital, 9300 DeWitt Loop, Fort Belvoir, VA 22060, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Brisson
authors.forename: Michael
authors.initials: M
authors.lastname: Woll
authors.forename: David
authors.initials: D
authors.lastname: Parker
authors.forename: Ronald
authors.initials: R
authors.lastname: Durbin
mesh_terms: D055826:Afghan Campaign 2001-; D000346:Afghanistan / Q000453:epidemiology; D000533:Altruism; D002675:Child, Preschool; D003950:Diagnostic Techniques, Urological; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008887:Military Medicine / Q000379:methods*; D012189:Retrospective Studies; D001744:Urinary Bladder Calculi / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000379:methods