Therapeutic possibilities for urolithiasis in childhood.
OBJECTIVE
We present our case studies on paediatric urolithiasis, the techniques employed in its treatment and its results.


METHODS
A retrospective study of paediatric urolithiasis of the upper urinary tract (UUT) treated at our centre 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 renal/urethral units in 32 patients. The median age was 5 years (range, 11 months-14 years). The mean size was 12.9cm (±7.3mm). 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 urethra. 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 urethra had a 100% success rate with the ureterorenoscopy. The overall cure rate was 90%.


CONCLUSIONS
The paediatric 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 centre, the use of paediatric extracorporeal shock wave lithotripsy is safer. Ureterorenoscopy, semirigid or flexible, provides excellent results in ureters. Percutaneous nephrolithotomy with minimal access can be performed on small children and nursing infants.
Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España. Electronic address: isabelsimal@gmail.com.
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Simal
Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España.
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Parente
Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España.
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Burgos
Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España.
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Ortiz
Servicio de Nefrología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España.
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Martínez
Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España.
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Rojo
Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España.
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Pérez-Egido
Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España.
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JM
Angulo
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008096:Lithotripsy; D053040:Nephrolithiasis / Q000628:therapy*; D012189:Retrospective Studies; D053039:Ureterolithiasis / Q000628:therapy*; D018666:Ureteroscopy
Lithotripsy; Litotricia; Miniperc; Nefrolitotomía percutánea; Percutaneous nephrolithotomy; Ureteroscopia; Ureteroscopy; Urolithiasis; Urolitiasis