[Management of pediatric urolithiasis in our center].
OBJECTIVE
To determine clinical, epidemiological and therapeutic characteristics of pediatric urolithiasis in our institution.


METHODS
We reviewed retrospectively patients diagnosed with urolithiasis between 1998 and 2010 in our hospital.


RESULTS
A total of 32 patients (19 males and 13 females) with a mean age of 4.5 years (SD 1.9) were studied. 72% had a history of metabolic or nephro-urological malformations. The most common presentation was urinary tract infection (53%) and abdominal pain (21%). The diagnosis was made by ultrasound, with compatible X-ray in 18 cases. The most common location was pyelocalyceal level, affecting the left kidney mostly. A 38% had multiple stones with a size of 11 mm medium (3-30 mm). Ureteroscopy was used 16 times for stones in the bladder and distal ureter, with an effectiveness of 75%, and 2 patients required laparoscopic trocar cystotomy for removal. 8 extracorporeal lithotripsy procedures were performed (25% success) and 8 percutaneous nephrolithotomy procedures (37.5% success). In 3 patients we decided to perform a lumbotomy due to the size of the calculi, and, in 1 patient nephrectomy was necessary due to malfunction. The most common complication was lithiasis recurrence in 10 patients, most with multiple stones or metabolic alterations, and favourable outcome for the rest.


CONCLUSIONS
Pediatric urolithiasis is uncommon, showing an increased incidence in patients with a history of metabolic and urologic pathology; it is important to do additional studies. In the last few years, it has been demonstrated that surgical treatment using minimally invasive procedures is effective and safe.
Servicio de Cirugía Pediátrica, Hospital Universitario Central de Asturias, Oviedo. cristinamontalvo_avalos@hotmail.com
C
C
Montalvo Avalos
Servicio de Cirugía Pediátrica, Hospital Universitario Central de Asturias, Oviedo.
A
A
Gómez Farpón
Servicio de Cirugía Pediátrica, Hospital Universitario Central de Asturias, Oviedo.
N
N
Vega Mata
Servicio de Cirugía Pediátrica, Hospital Universitario Central de Asturias, Oviedo.
A
A
López López
Servicio de Cirugía Pediátrica, Hospital Universitario Central de Asturias, Oviedo.
M
M
Oviedo Gutiérrez
Servicio de Cirugía Pediátrica, Hospital Universitario Central de Asturias, Oviedo.
J A
JA
Alvarez Zapico
D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D052878:Urolithiasis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*