Medical and surgical interventions for the treatment of urinary stones in children: A Cochrane Review

  • Lenka Barreto University Hospital Nitra
  • Jae Hung Jung
  • Ameera Abdelrahim
  • Munir Ahmed
  • Guy P.C. Dawkins
  • Marcin Kazmierski
Keywords: stones, children, treatment

Abstract

Introduction: We performed systematic review to assess the effects of different medical and surgical management of urinary stones in children.

Methods: We performed a comprehensive search using multiple databases (MEDLINE, EMBASE, Cochrane Register of Controlled Trials), trials registries (World Health Organization International Clinical Trials Registry Platform Search Portal and ClinicalTrials.gov), and abstract proceedings of major urological and paediatric urology meetings, with no restrictions on the language of publication or publication status, up until December 2017. We included all randomized controlled trials (RCTs) and quasi-RCTs. Two review authors independently assessed the eligibility of studies for inclusion, extracted data, and assessed risk of bias in accordance with the Cochrane ‘Risk of bias’ tool. We performed statistical analyses using a random-effects model and assessed the quality of the evidence according to GRADE.

Results: We included 14 studies with a total of 978 randomized participants in our review, informing seven comparisons with shock wave lithotripsy, percutaneous nephrolithotripsy, ureterorenoscopy (regardless of the type of lithotripsy), open stone surgery, and medical expulsive therapy. There was very low quality of evidence in the most comparisons with regards to the effectiveness and adverse events for the treatment of paediatric upper renal tract stone disease.

Conclusions: Based on mostly very low-quality evidence for most comparisons and outcomes, we are uncertain about the effect of nearly all medical and surgical interventions to treat stone disease in children. There is a critical need for better quality trials assessing patient-important outcomes in children with stone disease to inform future guidelines on the management of this condition.

References

Shah AM, Kalmunkar S, Punekar SV, et al. Spectrum of pediatric urolithiasis in Western India. Indian Journal of Pediatrics 1991;58(4):543–9.

Elsobky E, Sheir KZ, Madbouly K, et al. Extracorporeal shock wave lithotripsy in children: experience using two second-generation lithotripters. BJU International 2000;86(7):851–6.

Santos-Victoriano M, Brouhard BH, Cunningham RJ 3rd. Renal stone disease in children. Clinical Pediatrics 1998;37(10):583–99.

Dahm P, Sedrakyan A, McCulloch P. Application of the IDEAL Framework to Robotic Urologic Surgery. European Urology 2014;65(5):849–51.

Clayton DB, Pope JC. The increasing pediatric stone disease problem. Therapeutic Advances in Urology 2011;3(1):3–12.

Glina FP, Castro PM, Monteiro GG, et al. The use of alpha-1 adrenergic blockers in children with distal ureterolithiasis: a systematic review and meta-analysis. International Brazilian Journal of Urology 2015;41(6):1049–57.

Ishii H, Griffin S, Somani BK. Flexible ureteroscopy and lasertripsy (FURSL) for paediatric renal calculi: results from a systematic review. Journal of Pediatric Urology 2014;10(6):1020–5.

Ishii H, Griffin S, Somani BK. Ureteroscopy for stone disease in the paediatric population: a systematic review. BJU International 2015;115(6):867–73.

Tian D, Li N, Huang W, et al. The efficacy and safety of adrenergic alpha-antagonists in treatment of distal ureteral stones in pediatric patients: A systematic

review and meta-analysis. Journal of Pediatric Surgery 2017;52(2):360–5.

Velazquez N, Zapata D, Wang HH, et al. Medical expulsive therapy for pediatric urolithiasis: Systematic review and meta-analysis. Journal of Pediatric Urology 2015;11(6):321–7.

Higgins JP, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011.

Available from www.cochrane-handbook.org.

Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ 2003;327(7414):557–60.

Guyatt GH, Oxman AD, Vist GE et al. GRADE: what is “quality of evidence” and why is it important to clinicians? BMJ (Clinical Research Ed) 2008;336:995–8

Barreto L, Jung JH, AbdelrahimA, et al. Medical and surgical interventions for the treatment of urinary stones in children. Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No.: CD010784.

Aghamir SM, Salavati A, Aloosh M, et al. Feasibility of totally tubeless percutaneous nephrolithotomy under the age of 14 years: a randomized clinical trial. Journal of Endourology 2012;26(6):621–4.

Basiri A, Zare S, Tabibi A, et al. A multicenter, randomized, controlled trial of transureteral and shock wave lithotripsy which is the best minimally invasive modality to treat distal ureteral calculi in children?. Journal of Urology 2010;184(3):1106–9.

De Dominicis M, Matarazzo E, Capozza N, et al. Retrograde ureteroscopy for distal ureteric stone removal in children. BJU International 2005;95(7):1049–52.

Gamal W, Mmdouh A, Sogah. FURS vs shockwave lithotripsy for treatment of (1-2) cm renal stones in children with a solitary kidney: A prospective randomized study. The Journal of Urology. 2017;197:578.

Kumar A, Kumar N, Vasudeva P, et al. A single center experience comparing miniperc and shockwave lithotripsy for treatment of radiopaque 1-2 cm lower caliceal renal calculi in children: a prospective randomized study. Journal of Endourology / Endourological Society 2015;29(7):805.

Salem HK, Fathy H, Elfayoumy H, et al. Slow versus rapid delivery rate shock wave lithotripsy for pediatric renal urolithiasis: a prospective randomized study. The Journal of Urology 2014;191(5):1370.

Song G, Guo X, Niu G, et al. Advantages of tubeless mini-percutaneous nephrolithotomy in the treatment of preschool children under 3 years old. Journal of Pediatric Surgery 2015;50(4):655.

Aldaqadossi HA, Shaker H, SaifelnasrM, et al. Efficacy and safety of tamsulosin as a medical expulsive therapy for stones in children. Arab Journal of Urology 2015;13:107–11.

Aydogdu O, Burgu B, Gucuk A, et al. Effectiveness of doxazosin in treatment of distal ureteral stones in children. Journal of Urology 2009;182(6):2880–4.

Elgalaly H, Eliwa A, Seleem M, et al. Silodosin in the treatment of distal ureteric stones in children: A prospective, randomised, placebo-controlled

study. Arab Journal of Urology 2017;15:194–8.

Erturhan S, Bayrak O, Sarica K, et al. Efficacy of medical expulsive treatment with doxazosin in pediatric patients. Urology 2013;81(3):640–3.

Fahmy A, Rhasad H, Kamal A, et al. Silodosin for medical expulsive therapy in children with distal ureteral stone: a prospective randomized, placebo-controlled, single blind study. The Journal of Urology. 2017; Vol. 197:1217.

Mokhless I, Youssif M, Zahran A. Tamsulosin for the management of distal ureteral stones in children: a prospective randomized study [abstract no: S2-2]. 22nd Annual Congress of the European Society for PediatricUrology (ESPU); 2011 Apr 27-30; Copenhagen, Denmark. 2011.

Mokhless I, Zahran AR, Youssif M, et al. Tamsulosin for the management of distal ureteral stones in children: a prospective randomized study. Journal of Pediatric Urology

;8(5):544–8.

Elderwy A, Kurkar A, Hussein A-M, et al. Dissolution therapy versus shock wave lithotripsy for radiolucent renal stones in children: a prospective study. The Journal of Urology 2014;191(5):1491.

Saad KSM, Youssif ME, Hamdy S, et al. Percutaneous nephrolithotomy vs retrograde intrarenal surgery for large renal stones in pediatric patients: A randomized controlled trial. Source Journal of Urology Dec 2015;194(6):1716-20.

Sas DJ, Hulsey TC, Shatat IF, et al. Incidence of kidney stones in children evaluated in the ER is increasing. The Journal of Pediatrics 2010;157(1):132–7.

Borofsky MS, Shah O. Advances in ureteroscopy. Urologic Clinics of North America 2013;40(1):67–78.

Basiri A, Zare S, Sharifiaghdas F, et al. Comparison of ureteroscopy and extracorporeal shock wave lithotripsy in the treatment of distal ureteral calculi in children: A multicenteric randomized clinical trial [abstract]. Journal of Endourology 2009;23:A80.

Burgu B, Gucuk A, Soygur T. Use of doxazosin for pediatric distal ureter stones: results from prospective randomised study. Journal of Pediatric Urology 2009;5:S34.

Samad L, Zaidi Z. Tubed vs tubeless PCNL in children. JPMA - Journal of the Pakistan Medical Association 2012;62(9):892–6. MEDLINE: 23139970

Zaidi Z, Samad L. Tubeless vs tubed PCNL in children. Journal of Pediatric Urology 2009;5:S36–37.

Published
2019-03-22
How to Cite
Barreto, L., Jung, J. H., Abdelrahim, A., Ahmed, M., Dawkins, G. P., & Kazmierski, M. (2019). Medical and surgical interventions for the treatment of urinary stones in children: A Cochrane Review. Canadian Urological Association Journal, 13(10). https://doi.org/10.5489/cuaj.5787