Skip to main content
SpringerLink
Log in

Endourological Approaches to Renal and Ureteric Calculi in Children

  • Chapter
  • First Online:
Urolithiasis

  • 175 Accesses

Abstract

Pediatric urolithiasis is a management challenge because of the smaller size of the urinary tract and a higher risk of stone recurrence. The standard procedures to treat pediatric urolithiasis do not differ from those used for adults, i.e., extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureteroscopy (URS), laparoscopy, and open surgery. With improvement in equipment, energy sources, and increasing worldwide experience, open surgery is now limited to few cases requiring anatomical correction also. PCNL and URS can be performed in children with the same efficacy and safety as in adults.

This chapter describes endourological approaches (PCNL and URS) to management of pediatric urolithiasis. PCNL since its first report in the 1970s has undergone much refinement as a procedure, and indications for its use have expanded many folds. This chapter traces the history of PCNL, a very detailed account of step-by-step technique, and discusses PCNL in conditions like bilateral stones and congenital abnormalities. The instruments used, the complications of PCNL, and the effectiveness of this procedure in managing renal stones in children have been described in detail.

Management of ureteric stones with URS in children has been described with a detailed account of the procedure, its complications, and outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Afshar K, Mclorie G, Papanikolaou F, Pippi Salle JL, Bagli DJ, Khoury AE. Outcome of small residual stone fragments following shock wave lithotripsy in children. J Urol. 2004;172:1600–3.

    Article  PubMed  Google Scholar 

  2. Fernstorm I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol. 1976;10:257–9.

    Google Scholar 

  3. Rusnak B, Castaneda-Zuniga W, Kotula F, Herrera M, Amplatz K. An improved dilator system for percutaneous nephrostomies. Radiology. 1982;144:174.

    PubMed  CAS  Google Scholar 

  4. Alken P. Telescopbougierst zur perkutanen nephrostomie. Akt Urol. 1981;12:216–9.

    Article  Google Scholar 

  5. Clayman RV, Castaneda-Zuniga WR, Hunter DW, Miller RP, Lange PH, Amplatz K. Rapid balloon dilatation of nephrostomy track for nephrostolithotomy. Radiology. 1983;147:884–5.

    PubMed  CAS  Google Scholar 

  6. Woodside JR, Stevens JF, Strak JL, Borden TA, Ball WS. Percutaneous stone removal in children. J Urol. 1985;134:1166–7.

    PubMed  CAS  Google Scholar 

  7. Mor Y, Elmarsy YE, Kellet MJ, Duffy PG. The role of percutaneous nephrolithotomy in the management of pediatric renal calculi. J Urol. 1997;158:1319–21.

    Article  PubMed  CAS  Google Scholar 

  8. Helal M, Black T, Lockhart J, Figueroa TE. The Hickman peel-away sheath: alternative for pediatric percutaneous nephrolithotomy. J Endourol. 1997;11:171–2.

    Article  PubMed  CAS  Google Scholar 

  9. Samad L, Aquil S, Zaidi Z. Pediatric percutaneous nephrolithotomy: setting new frontiers. BJU Int. 2006;97:353–63.

    Article  Google Scholar 

  10. Wu HY, Docimo SG. Surgical management of children with urolithiasis. Urol Clin North Am. 2004;31:589–94.

    Article  PubMed  Google Scholar 

  11. Farhat WA, Kropp BP. Surgical treatment of pediatric urinary stones. AUA Update Ser. 2007;26:22.

    Google Scholar 

  12. Mendez Probost CE, Denstedt JD, Razvi H. Preoperative indications for percutaneous nephrolithotomy in 2009. J Endourol. 2009;23:1557–61.

    Article  Google Scholar 

  13. Dogan HS, Sahin A, Cetinkaya Y, Akdogan B, Ozden E, Kendi S. Antibiotic prophylaxis in percutaneous nephrolithotomy: prospective study in 81 patients. J Endourol. 2002;16:649–53.

    Article  PubMed  Google Scholar 

  14. Charton M, Vallencien G, Veillon B, et al. Urinary tract infection in percutaneous surgery for renal calculi. J Urol. 1986;135:15–7.

    PubMed  CAS  Google Scholar 

  15. Clayman RV, Casteneda-Zuniga WR. Techniques in endourology. A guide to percutaneous removal of renal and ureteral calculi. Chicago: Year Book Medical Publishers; 1984.

    Google Scholar 

  16. Wolf Jr JS, Bennet CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ. Urological surgery antimicrobial prophylaxis best practice policy panel. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179:1379–90.

    Article  PubMed  Google Scholar 

  17. Grabe M, Bishop MC, Bjerklund-Johansen TE, Botto H, et al. European Association of Urology. Guidelines on urological infections (updated 2009). European Guidelines office (publ). Web access: www.uroweb.org. Accessed on March 20, 2011.

  18. Rozentsveig V, Neulander EZ, Gurevich B, Klein Y, Weksler N. Anesthetic consideration during percutaneous nephrolithotomy. J Clin Anesth. 2007;19:351–5.

    Article  PubMed  Google Scholar 

  19. Frank SM, Kluger MJ, Kunkel SL. Elevated thermostatic setpoint in postoperative patients. Anesthesiology. 2000;93:1426–31.

    Article  PubMed  CAS  Google Scholar 

  20. Ost MC, Lee BR. Urolithiasis in patients with spinal cord injuries: risk factors, management and outcomes. Curr Opin Urol. 2006;16:93–9.

    Article  PubMed  Google Scholar 

  21. Mahmud M, Zaidi Z. Percutaneous nephrolithotomy in children before school age: experience of a Pakistani center. BJU Int. 2004;94:1352–4.

    Article  PubMed  Google Scholar 

  22. Schuster TK, Smaldone MC, Averch TD, Ost MC. Percutaneous nephrolithotomy in children. J Endourol. 2009;23:1699–705.

    Article  PubMed  Google Scholar 

  23. Wezel F, Charalampos M, Jorge R, Maurice SM, de la Rosette J, Alken P. Two contemporary series of percutaneous tract dilatation for percutaneous nephrolithotomy. J Endourol. 2009;23:1655–61.

    Article  PubMed  Google Scholar 

  24. Jackman SV, Docimo SG, Cadeddu JA, Bishoff JT, Kavoussi LR, Jarrett TW. The “mini-perc” technique: a less invasive alternative to percutaneous nephrolithotomy. World J Urol. 1998;16:371–4.

    Article  PubMed  CAS  Google Scholar 

  25. Sung YM, Choo SW, Jeon SS, Shin SW, Park KB, Do YS. The “mini-perc” technique of percutaneous nephrolithotomy with a 14-Fr peel-away sheath: 3 year results in 72 patients. Korean J Radiol. 2006;7:50–6.

    Article  PubMed  Google Scholar 

  26. Guisiti G, Seveso M, Taverna G, Piccinelli A, Graziotti P. Miniperc ? No thank you. Eur Urol Suppl. 2006;5:110.

    Article  Google Scholar 

  27. Bilen CY, Kocak B, Kitirci G. Percutaneous nephrolithotomy in children: lessons learned in 5 years at a single institution. J Urol. 2007;177:1867–71.

    Article  PubMed  Google Scholar 

  28. Nouralizadeh A, Basiri A, Javaherforooshzadeh A, Soltani MH, Tajali F. Experience of percutaneous nephrolithotomy using adult size instruments in children less than 5 years old. J Pediatr Urol. 2009;5:351–4.

    Article  PubMed  Google Scholar 

  29. Smaldone MC, Gayed BA, Ost MC. The evolution of the endourological management of pediatric stone disease. Indian J Urol. 2009;25:302–11.

    Article  PubMed  Google Scholar 

  30. Srinivasan AK, Herati A, Okeke Z, Smith A. Renal drainage after percutaneous nephrolithotomy. J Endourol. 2009;23:1743–9.

    Article  PubMed  Google Scholar 

  31. Limb J, Bellman GC. Tubeless percutaneous renal surgery: review of first 112 patients. Urology. 2002;59:527–31.

    Article  PubMed  Google Scholar 

  32. Yoon GH, Bellman GC. Tubeless percutaneous nephrolithotomy: a new standard in percutaneous renal surgery. J Endourol. 2008;9:1865–9.

    Article  Google Scholar 

  33. Khairy Salem H, Morsi HA, Omran A, Daw MA. Tubeless percutaneous nephrolithotomy in children. J Pediatr Urol. 2007;3:235–8.

    Article  PubMed  CAS  Google Scholar 

  34. Zaidi Z, Samad L. Tubeless vs tubed PCNL in children. J Pediatr Urol. 2009;5(S1):36–7.

    Article  Google Scholar 

  35. Ozturk A, Guven S, Kilinc M, Topbas E, Piskin M, Arslan M. Totally tubeless percutaneous nephrolithotomy: is it safe and effective in preschool children? J Endourol. 2010;24:1935–9.

    Article  PubMed  Google Scholar 

  36. Salah MA, Tallai B, Holman E, Khan MA, Toth G, Toth C. Simultaneous bilateral percutaneous nephrolithotomy in children. BJU Int. 2005;95:137–9.

    Article  PubMed  Google Scholar 

  37. Choong S, Whitfield H, Duffy P. The management of pediatric urolithiasis. BJU Int. 2000;86:857–60.

    Article  PubMed  CAS  Google Scholar 

  38. Desai MR, Jasani A. Percutaneous nephrolithotripsy in ectopic kidneys. J Endourol. 2000;14:289–92.

    Article  PubMed  CAS  Google Scholar 

  39. Razvi S, Zaidi Z. Percutaneous nephrolithotomy (PCNL) in horse-shoe kidneys. J Pak Med Assoc. 2007;57:222–4.

    PubMed  Google Scholar 

  40. Aquil S, Rana AM, Zaidi Z. Laparoscopic assisted percutaneous nephrolithotomy in ectopic pelvic kidney. J Pak Med Assoc. 2006;5:381–3.

    Google Scholar 

  41. Desai MR, Kukreja RA, Patel SH. Percutaneous nephrolithotomy for complex pediatric renal calculus disease. J Endourol. 2004;18:23–7.

    Article  PubMed  Google Scholar 

  42. Zaren S, Satar N, Bayazit Y, Bayazit AK, Payasli K, Ozkeceli R. Percutaneous nephrolithotomy in the management of pediatric renal calculi. J Endourol. 2002;16:75–8.

    Article  Google Scholar 

  43. Salah MA, Toth C, Khan MA, Holman E. Percutaneous nephrolithotomy in children: experience with 138 cases in a developing country. World J Urol. 2004;22:227–80.

    Article  Google Scholar 

  44. Turna B, Nazli O, Demiryoguran S, Mammadov R, Cal C. Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology. 2007;69:603–7.

    Article  PubMed  Google Scholar 

  45. Bogris S, Papatsoris AG. Status quo of percutaneous nephrolithotomy in children. Urol Res. 2010;38:1–5.

    Article  PubMed  Google Scholar 

  46. Kukreja RA, Desai MR, Sabnis RB, Patel SH. Fluid absorption during percutaneous nephrolithotomy: does it matter? J Endourol. 2002;16:221–4.

    Article  PubMed  CAS  Google Scholar 

  47. Shokeir AA, Sheir KZ, El-Nahas AR, El-Assmy AM, Eassa W, El-Kappany HA. Treatment of renal stones in children; a comparison between percutaneous nephrolithotomy and shock wave lithotripsy. J Urol. 2006;176:706–10.

    Article  PubMed  Google Scholar 

  48. Holman E, Khan AM, Flasko T, Toth C, Salah MA. Endoscopic management of pediatric urolithiasis in a developing country. Urology. 2004;63:159–62.

    Article  PubMed  Google Scholar 

  49. Dawaba MS, Shokeir AA, Hafez AT, et al. Percutaneous nephrolithotomy in children: early and late anatomical and functional results. J Urol. 2004;172:1078–81.

    Article  PubMed  Google Scholar 

  50. Nouralizadeh A, Sichani MM, Kashi AK. Impact of percutaneous nephrolithotomy on estimated glomerular filtration rate during the first few days after surgery. Urol Res. 2011;39:129–33.

    Article  PubMed  Google Scholar 

  51. Samad L, Qureshi S, Zaidi Z. Does percutaneous nephrolithotomy in children cause significant renal scarring? J Pediatr Urol. 2007;3:36–9.

    Article  PubMed  Google Scholar 

  52. De la Rosette JJMCH, Laguna MP, Rassweiler JJ, Conort P. Training in percutaneous nephrolithotomy – a critical review. Eur Urol. 2008;54:994–1003.

    Article  PubMed  Google Scholar 

  53. Young HM, McKay RW. Congenital valvular obstruction of the prostatic urethra. Surg Gyencol Obstet. 1929;48:509.

    Google Scholar 

  54. Ritchey M, Patterson DE, Kelalis PP. A case of pediatric ureteroscopic lasertripsy. J Urol. 1988;139(6):1272–4.

    PubMed  CAS  Google Scholar 

  55. Van Savage JG, Palanca LG, Andersen RD, Rao GS, Slaughenhoupt BL. Treatment of distal ureteral stones in children: similarities to American urological association guidelines in adults. J Urol. 2000;164:1089–93.

    Article  PubMed  Google Scholar 

  56. Turk C, Knoll T, Petrik A, Sarcia K, Seitz C, Straub M, Traxer O. Guidelines on urolithiasis. 2010. European Guidelines Office (publ) Web access: www.uroweb.org/guidelines/urolithiasis. Accessed on March 20, 2011.

  57. Assimos DG, Patterson LC, Taylor CL. Changing incidence and etiology of iatrogenic ureteral injuries. J Urol. 1994;152:2240.

    PubMed  CAS  Google Scholar 

  58. Lam JS, Cooper KL, Green TD, et al. Impact of hydronephrosis and renal function on treatment outcomes: antegrade versus retrograde endopyelotomy. Urology. 2003;61:1107.

    Article  PubMed  Google Scholar 

  59. Reddy PP. Pediatric ureteroscopy. Urol Clin North Am. 2004;31:145–56.

    Article  PubMed  Google Scholar 

  60. Korkes F, Lopes-Neto AC, Mattos MH, Pompeo AC, Wroclawski ER. Patient position and semirigid ureteroscopy outcomes. Int Braz J Urol. 2009;35:542–50.

    Article  PubMed  Google Scholar 

  61. Shepherd P, Thomas R, Harmon EP. Urolithiasis in children: innovations in management. J Urol. 1988;140:790–2.

    PubMed  CAS  Google Scholar 

  62. Bassiri A, Ahmadnia H, Darabi MR, Yonessi M. Transureteral lithotripsy in pediatric practice. J Endourol. 2002;16:257.

    Article  PubMed  CAS  Google Scholar 

  63. Caione P, De Gennaro M, Capozza N, et al. Endoscopic manipulation of ureteral calculi in children by rigid operative ureteroscopy. J Urol. 1990;144:484–9.

    PubMed  CAS  Google Scholar 

  64. Hill DE, Segura JW, Patterson DE, Kramer SA. Ureteroscopy in children. J Urol. 1990;144:481–3.

    PubMed  CAS  Google Scholar 

  65. Thomas R, Ortenberg J, Lee BR, et al. Safety and efficacy of pediatric ureteroscopy for management of calculous disease. J Urol. 1993;149:1082–4.

    PubMed  CAS  Google Scholar 

  66. Schuster TG, Russell KY, Bloom DA, Koo HP, Faerber GJ. Ureteroscopy for the treatment of urolithiasis in children. J Urol. 2002;167:1813–6. discussion 1815–6.

    Article  PubMed  Google Scholar 

  67. Soygur T, Zumrutbas AE, Gulpinar O, Suer E, Arikan N. Hydrodilation of the ureteral orifice in children renders ureteroscopic access possible without any further active dilation. J Urol. 2006;176:285–7.

    Article  PubMed  Google Scholar 

  68. Gedik A, Orgen S, Akay AF, Sahin H, Bircan MK. Semirigid ureterorenoscopy in children without ureteral dilation. Int Urol Nephrol. 2008;40:11–4.

    Article  PubMed  Google Scholar 

  69. Singh A, Shah G, Young J, Sheridan M, Haas G, Upadhyay J. Ureteral access sheath for the management of pediatric renal and ureteral stones. A single center experience. J Urol. 2006;175:1080–2.

    Article  PubMed  Google Scholar 

  70. Satar N, Zeren S, Bayazit Y, Aridogan IA, Soyupak B, Tansug Z. Rigid ureteroscopy for treatment of ureteral calculi in children. J Urol. 2004;172:298–300.

    Article  PubMed  Google Scholar 

  71. Tanriverdi O, Silay MS, Kendirci M, Kadihasnoglu M, Aydin M, Horasanli K, et al. Comparison of ureteroscopic procedures with rigid and semirigid ureteroscopes in pediatric population: does the caliber of instrument matter? Pediatr Surg Int. 2010;26:733–8.

    Article  PubMed  Google Scholar 

  72. Kim SS, Kolon TF, Canter D, White M, Casale P. Pediatric flexible ureteroscopic lithotripsy: the Children’s hospital of Philadelphia experience. J Urol. 2008;180:2616–9.

    Article  PubMed  Google Scholar 

  73. Rubenstein RA, Zhao LC, Loeb S, Shore DM, Nadler RB. Prestenting improves ureteroscopic stone free rates. J Endourol. 2007;21:1277.

    Article  PubMed  Google Scholar 

  74. Hubert KC, Palmer JS. Passive dilation by ureteral stenting before ureteroscopy: eliminating the need for active dilation. J Urol. 2005;174:1079–81.

    Article  PubMed  Google Scholar 

  75. Corcoran AT, Smaldone MC, Mally D, Ost MC, Bellinger MF, Schneck FX, et al. When is prior ureteral stent placement necessary to access the upper urinary tract in prepubertal children. J Urol. 2008;180:1861–4.

    Article  PubMed  Google Scholar 

  76. Safwat AS, Bissada NK, Kumar U, Taha MI, Abdel-hafez SES, Eltaher AM, et al. Experience with ureteroscopic holmium laser lithotripsy in children. Pediatr Surg Int. 2008;24:579–81.

    Article  PubMed  Google Scholar 

  77. Binbay M, Tepler A, Yuruk E, Sarilar O, Ozkuvanci U, Muslumanoglu AY. Comparative evaluation of pneumatic versus holmium:YAG laser lithotripsy for impacted ureteral stones. In: EAU 5th south eastern European meeting/European urology supplement, 2009, vol. 8, p. 607–55.

    Google Scholar 

  78. Fuganti PE, Pires SR, Branco RO, Porto JL. Ballistic ureteroscopic lithotripsy in prepubertal patients: a feasible option for ureteral stones. Int Braz J Urol. 2006;32:322–9.

    Article  PubMed  Google Scholar 

  79. Pryor JL, Langley MJ, Jenkins AD. Comparison of symptoms characteristic of indwelling ureteral catheters. J Urol. 1991;145:719.

    PubMed  CAS  Google Scholar 

  80. Smaldone MC, Cannon GM, Wu HY, Basett J, Polsky EG, Bellinger MF, et al. Is ureteroscopy first line treatment for pediatric stone disease? J Urol. 2007;178:2128–31.

    Article  PubMed  Google Scholar 

  81. Byrne RR, Auge BK, Kourambas J, Munver R, Delvecchio F, Preminger GM. Routine ureteral stenting is not necessary after ureteroscopy and ureteropyeloscopy: a randomized trial. J Endourol. 2002;16(1):9–13.

    Article  PubMed  Google Scholar 

  82. Rizvi SA, Naqvi SA, Hussain Z, Hashmi A, Hussain M, Zafar MN, et al. Management of pediatric urolithiasis in Pakistan: experience with 1,440 children. J Urol. 2003;169(2):634–7.

    Article  PubMed  CAS  Google Scholar 

  83. Cybulski P, Honey RJ, Pace K. Fluid absorption during ureterorenoscopy. J Endourol. 2004;18(8):739–42.

    Article  PubMed  Google Scholar 

  84. Minevich E, Defoor W, Reddy P, Nishinaka K, Waksman J, Sheldon C, et al. Ureteroscopy is safe and effective in prepubertal children. J Urol. 2005;174:276–9. discussion 279.

    Article  PubMed  Google Scholar 

  85. De Dominicis M, Matarazzo E, Capozza N, Collura G, Caione P. Retrograde ureteroscopy for distal ureteric stone removal in children. BJU Int. 2005;95:1049–52.

    Article  PubMed  Google Scholar 

  86. Reddy PP, DeFoor WR. Ureteroscopy: the standard of care in the management of upper tract urolithiasis in children. Indian J Urol. 2010;26:555–63.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, The Indus Hospital, Korangi Crossing, Karachi, 75190, Pakistan

    Zafar Zaidi M.B.B.S., FRCS, FEBU & Zaheer Alam M.B.B.S., MCPS, FCPS Urology

Authors
  1. Zafar Zaidi M.B.B.S., FRCS, FEBU
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zaheer Alam M.B.B.S., MCPS, FCPS Urology
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zafar Zaidi M.B.B.S., FRCS, FEBU .

Editor information

Editors and Affiliations

  1. Department of Surgery Section of Urology, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan

    Jamsheer J. Talati

  2. Karolinska Institutet, Solnavägen 1, Solna, Stockholm, 171 77, Sweden

    Hans-Goran Tiselius

  3. , Syracuse University, Crouse Hospital, 1226 East Water Street, New York, 13210, New York, USA

    David M. Albala

  4. , Department of Urology, Tongji Hospital, 1095 Jiefang Avenue, Wuhan, 430030, China, People's Republic

    ZHANGQUN YE

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag London

About this chapter

Cite this chapter

Zaidi, Z., Alam, Z. (2012). Endourological Approaches to Renal and Ureteric Calculi in Children. In: Talati, J., Tiselius, HG., Albala, D., YE, Z. (eds) Urolithiasis. Springer, London. https://doi.org/10.1007/978-1-4471-4387-1_83

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4387-1_83

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4383-3

  • Online ISBN: 978-1-4471-4387-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation