Pediatric urolithiasis: experience at a tertiary care pediatric hospital
DOI:
https://doi.org/10.5489/cuaj.804Abstract
Objective: We aimed to determine the epidemiology, risk factors, clinical characteristics, evaluation and course of patients with urolithiasis at the Children’s Hospital of Eastern Ontario to improve current diagnostic and management strategies.
Methods: This was a retrospective study of children with newly identified urolithiasis between Jan. 1, 1999, and July 31, 2004. Cases were reviewed for demographics, presentation, family history, diagnostic methods and findings, metabolic and anatomic abnormalities, management, stone analysis and stone recurrence.
Results: Seventy-two patients (40 male, 32 female; mean age 11.3 yr) were assessed. Mean follow-up was at 1.5 years. Eighteen patients (25%) had a family history of stones. Flank pain (63%) was the most common presentation. Eighty-two percent of urinalyses showed microscopic hematuria. Imaging comprised abdominal plain film radiography (56%) and (or) abdominal ultrasonography (74%). The mean stone size was 5 mm. Forty-one percent (28/69) of patients who underwent metabolic investigation had an abnormality. Fourteen percent of patients (10/72) had a genitourinary anatomical abnormality. Thirty-four patients (47%) passed their stones spontaneously, 25 patients (35%) required surgical intervention and 13 patients (18%) had yet to pass their stone. The mean size of spontaneously passed stones was 4 mm. Of 42 stones analyzed, 39 (93%) were composed of calcium oxalate or phosphate. Seventeen (24%) patients had stone recurrence during follow-up.
Conclusion: Pediatric patients with stones present in a manner similar to adults. Abdominal plain film radiography and ultrasonography are the preferred initial radiological investigations in children as they limit radiation exposure. Metabolic abnormalities are common and may coexist with anatomic abnormalities, therefore investigations must rule these out. One-half of patients will pass their stones spontaneously. Recurrence rates are high and long-term follow-up is recommended.
Downloads
Downloads
How to Cite
Issue
Section
License
You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:
- Post the Article on any Web site
- Translate or authorize a translation of the Article
- Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
- Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.
The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.
You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.
The CUA also requires you to warrant the following:
- That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
- That all individuals who have made a substantive contribution to the article are acknowledged;
- That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
- That the Article does not libel or violate the privacy rights of any third party.