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Pediatric Nephrology

, Volume 25, Issue 7, pp 1239–1244 | Cite as

Pediatric urolithiasis: the current surgical management

  • Michael StraubEmail author
  • Jürgen Gschwend
  • Christoph Zorn
Educational Review

Abstract

Children represent about 1% of all patients with urolithiasis, but 100% of these children are considered high risk for recurrent stone formation, and it is crucial for them to receive a therapy that will render them stone free. In addition, a metabolic workup is necessary to ensure a tailored metaphylaxis to prevent or delay recurrence. The appropriate therapy depends on localization, size, and composition of the calculus, as well as on the anatomy of the urinary tract. In specialized centers, the whole range of extracorporeal shock-wave lithotripsy (ESWL), ureterorenoscopy (URS), and percutaneous nephrolithotomy (PCNL) are available for children, with the same efficiency and safety as in adults.

Keywords

ESWL PCNL URS Urolithiasis Children Pediatric urolithiasis Endoscopy 

Notes

References

  1. 1.
    Straub M, Strohmaier WL, Berg W, Beck B, Hoppe B, Laube N, Lahme S, Schmidt M, Hesse A, Koehrmann KU (2005) Diagnosis and metaphylaxis of stone disease. Consensus concept of the national working committee on stone disease for the upcoming german urolithiasis guideline. World J Urol 23:309–323CrossRefPubMedGoogle Scholar
  2. 2.
    Kroovand RL (1997) Pediatric urolithiasis. Urol Clin North Am 24:173–184CrossRefPubMedGoogle Scholar
  3. 3.
    Minevich E (2001) Pediatric urolithiasis. Pediatr Clin North Am 48:1571–1585CrossRefPubMedGoogle Scholar
  4. 4.
    Nijman RJ, Ackaert K, Scholtmeijer RJ, Lock TW, Schröder FH (1989) Long-term results of extracorporeal shock wave lithotripsy in children. J Urol 142:609–611, discussion 619PubMedGoogle Scholar
  5. 5.
    Afshar K, McLorie G, Papanikolaou F, Malek R, Harvey E, Pippi-Salle JL, Bagli DJ, Khoury AE, Farhat W (2004) Outcome of small residual stone fragments following shock wave lithotripsy in children. J Urol 172:1600–1603CrossRefPubMedGoogle Scholar
  6. 6.
    Chaussy C, Brendel W, Schmiedt E (1980) Extracorporeally induced destruction of kidney stones by shock waves. Lancet 2:1265–1268CrossRefPubMedGoogle Scholar
  7. 7.
    Newman DM, Coury T, Lingeman JE (1986) Extracorporeal shock wave lithotripsy experience in children. J Urol 136:238–240PubMedGoogle Scholar
  8. 8.
    Chaussy CG, Fuchs GJ (1989) Current state and future developments of noninvasive treatment of human urinary stones with extracorporeal shock wave lithotripsy. J Urol 141:782–789PubMedGoogle Scholar
  9. 9.
    Brinkmann OA, Griehl A, Kuwertz-Bröking E, Bulla M, Hertle L (2001) Extracorporeal shock wave lithotripsy in children. Efficacy, complications and long-term follow-up. Eur Urol 39:591–597CrossRefPubMedGoogle Scholar
  10. 10.
    Lottmann HB, Archambaud F, Hellal B, Pageyral BM, Cendron M (1998) 99mTechnetium-dimercapto-succinic acid renal scan in the evaluation of potential long-term renal parenchymal damage associated with extracorporeal shock wave lithotripsy in children. J Urol 159:521–524CrossRefPubMedGoogle Scholar
  11. 11.
    Vlajković M, Slavković A, Radovanović M, Sirić Z, Stefanović V, Perović S (2002) Long-term functional outcome of kidneys in children with urolithiasis after ESWL treatment. Eur J Pediatr Surg 12:118–123CrossRefPubMedGoogle Scholar
  12. 12.
    Constantinides C, Recker F, Jaeger P, Hauri D (1989) Extracorporeal shock wave lithotripsy as monotherapy of staghorn renal calculi: 3 years of experience. J Urol 142:1415–1418PubMedGoogle Scholar
  13. 13.
    Anderson P, Norman R, Award S (1989) Extracorporeal shock wave lithotripsy experience with large renal calculi. J Endourol 3:31–36CrossRefGoogle Scholar
  14. 14.
    Reisiger K, Vardi I, Yan Y, Don S, Coplen D, Austin P, Venkatesh R, Bhayani S, Hmiel P, Figenshau R (2007) Pediatric nephrolithiasis: does treatment affect renal growth? Urology 69:1190–1194CrossRefPubMedGoogle Scholar
  15. 15.
    Goel MC, Baserge NS, Babu RV, Sinha S, Kapoor R (1996) Pediatric kidney: functional outcome after extracorporeal shock wave lithotripsy. J Urol 155:2044–2046CrossRefPubMedGoogle Scholar
  16. 16.
    Krambeck AE, Gettman MT, Rohlinger AL, Lohse CM, Patterson DE, Segura JW (2006) Diabetes mellitus and hypertension associated with shock wave lithotripsy of renal and proximal ureteral stones at 19 years of followup. J Urol 75:1742–1747CrossRefGoogle Scholar
  17. 17.
    Whitfield HN (2007) Re: Diabetes mellitus and hypertension associated with shock wave lithotripsy of renal and proximal ureteral stones at 19 years of followup. Eur Urol 51:281–822CrossRefPubMedGoogle Scholar
  18. 18.
    Knoll T, Janitzky V, Michel MS, Alken P, Köhrmann KU (2003) Cystinuria - cystine stones: recommendations for diagnosis, therapy and follow-up. Aktuelle Urol 34:97–101CrossRefPubMedGoogle Scholar
  19. 19.
    Kuvezdić H, Tucak A, Perić N, Prlić D, Zorić I, Galić R (2003) ESWL treatment of urinary stones in children-the overview of 14 years of experience. Coll Antropol 27(Suppl 1):71–75PubMedGoogle Scholar
  20. 20.
    Tekgül S, Riedmiller H, Gerharz E, Hoebeke P, Kocvara R, Nijman R, Radmayr C, Stein R (2009) Guidelines on Paediatric Urology. Arnhem, The Netherlands: European Association of Urology, European Society for Paediatric Urology, pp 52–63Google Scholar
  21. 21.
    Rodrigues Netto N, Longo JA, Ikonomidis JA, Rodrigues Netto M (2002) Extracorporeal shock wave lithotripsy in children. J Urol 167:2164–2166CrossRefPubMedGoogle Scholar
  22. 22.
    Brien G, Bick C, Kirschner P, Althaus P, Tutschku E, Christoph S (1990) ESWL with the Lithostar-experience with 3, 000 treatments. Z Urol Nephrol 83:663–671PubMedGoogle Scholar
  23. 23.
    Sampaio FJ, Aragao AH (1992) Inferior pole collecting system anatomy: its probable role in extracorporeal shock wave lithotripsy. J Urol 147:322–324PubMedGoogle Scholar
  24. 24.
    Ozgür Tan M, Karaoğlan U, Sözen S, Bozkirli I (2003) Extracorporeal shock-wave lithotripsy for treatment of ureteral calculi in pediatric patients. Pediatr Surg Int 19:471–474CrossRefPubMedGoogle Scholar
  25. 25.
    Ozgür Tan M, Karaoğlan U, Sen I, Deniz N, Bozkirli I (2003) The impact of radiological anatomy in clearance of lower calyceal stones after shock wave lithotripsy in pediatric patients. Eur Urol 43:188–193CrossRefPubMedGoogle Scholar
  26. 26.
    Demirkesen O, Onal B, Tansu N, Altintaş R, Yalçin V, Oner A (2006) Efficacy of extracorporeal shock wave lithotripsy for isolated lower caliceal stones in children compared with stones in other renal locations. Urology 67:170–174, discussion 174–175CrossRefPubMedGoogle Scholar
  27. 27.
    Onal B, Demirkesen O, Tansu N, Kalkan M, Altintaş R, Yalçin V (2004) The impact of caliceal pelvic anatomy on stone clearance after shock wave lithotripsy for pediatric lower pole stones. J Urol 172:1082–1086CrossRefPubMedGoogle Scholar
  28. 28.
    Sternberg K, Greenfield SP, Williot P, Wan J (2005) Pediatric stone disease: an evolving experience. J Urol 174:1711–1714, discussion 1714CrossRefPubMedGoogle Scholar
  29. 29.
    Rhee K, Palmer JS (2006) Ungated extracorporeal shock wave lithotripsy in children: an initial series. Urology 67:392–393CrossRefPubMedGoogle Scholar
  30. 30.
    Braun P, Hoang-Böhm J, Martinez Portillo F, Scheepe JR, Jünemann KP, Alken P, Köhrmann KU (2000) Therapie der Urolithiasis im Kindesalter Extrakorporale Stoßwellenbehandlung (ESWL) und Auxiliarmaßnahmen. Monatsschr Kinderheilkd 148:1012–1016CrossRefGoogle Scholar
  31. 31.
    Cervenàkov I, Fillo J, Mardiak J, Kopecný M, Smirala J, Lepies P (2002) Speedy elimination of ureterolithiasis in lower part of ureters with the alpha 1-blocker-Tamsulosin. Int Urol Nephrol 34:25–29CrossRefPubMedGoogle Scholar
  32. 32.
    Dellabella M, Milanese G, Muzzonigro G (2003) Efficacy of tamsulosin in the medical management of juxtavesical ureteral stones. J Urol 170:2202–2205CrossRefPubMedGoogle Scholar
  33. 33.
    Lahme S (2006) Shockwave lithotripsy and endourological stone treatment in children. Urol Res 34:112–117CrossRefPubMedGoogle Scholar
  34. 34.
    Sarica K, Erturhan S, Yurtseven C, Yagci F (2006) Effect of potassium citrate therapy on stone recurrence and regrowth after extracorporeal shockwave lithotripsy in children. J Endourol 20:875–879CrossRefPubMedGoogle Scholar
  35. 35.
    Aldridge RD, Aldridge RC, Aldridge LM (2006) Anesthesia for pediatric lithotripsy. Paediatr Anaesth 16:236–241CrossRefPubMedGoogle Scholar
  36. 36.
    Woodside JR, Stevens GF, Stark GL, Borden TA, Ball WS (1985) Percutaneous stone removal in children. J Urol 134:1166–1167PubMedGoogle Scholar
  37. 37.
    Jackman SV, Hedican SP, Peters CA, Docimo SG (1998) Percutaneous nephrolithotomy in infants and preschool age children: experience with a new technique. Urology 52:697–701CrossRefPubMedGoogle Scholar
  38. 38.
    Desai MR, Kukreja RA, Patel SH, Bapat SD (2004) Percutaneous nephrolithotomy for complex pediatric renal calculus disease. J Endourol 18:23–27CrossRefPubMedGoogle Scholar
  39. 39.
    Badawy H, Salama A, Eissa M, Kotb E, Moro H, Shoukri I (1999) Percutaneous management of renal calculi: experience with percutaneous nephrolithotomy in 60 children. J Urol 162:1710–1713CrossRefPubMedGoogle Scholar
  40. 40.
    Dawaba MS, Shokeir AA, Hafez AT, Shoma AM, El-Sherbiny MT, Mokhtar A, Eraky I, El-Kenawy M, El-Kappany HA (2004) Percutaneous nephrolithotomy in children: early and late anatomical and functional results. J Urol 172:1078–1081CrossRefPubMedGoogle Scholar
  41. 41.
    Sahin A, Tekgül S, Erdem E, Ekici S, Hasçiçek M, Kendi S (2000) Percutaneous nephrolithotomy in older children. J Pediatr Surg 35:1336–1338CrossRefPubMedGoogle Scholar
  42. 42.
    Wu H, Docimo SG (2004) Surgical management of children with urolithiasis. Urol Clin North Am 31:589–594CrossRefPubMedGoogle Scholar
  43. 43.
    Mayo ME, Krieger JN, Rudd TG (1985) Effect of percutaneous nephrostolithotomy on renal function. J Urol 133:167–169PubMedGoogle Scholar
  44. 44.
    Salah MA, Tóth C, Khan AM, Holman E (2004) Percutaneous nephrolithotomy in children: experience with 138 cases in a developing country. World J Urol 22:277–280CrossRefPubMedGoogle Scholar
  45. 45.
    Salah MA, Tállai B, Holman E, Khan MA, Tóth G, Tóth C (2005) Simultaneous bilateral percutaneous nephrolithotomy in children. BJU Int 95:137–139CrossRefPubMedGoogle Scholar
  46. 46.
    Zeren S, Satar N, Bayazit Y, Payasli K, Ozkeçeli R (2002) Percutaneous nephrolithotomy in the management of pediatric renal calculi. J Endourol 16:75–78CrossRefPubMedGoogle Scholar
  47. 47.
    Boormans JL, Scheepe JR, Verkoelen CF, Verhagen PC (2005) Percutaneous nephrolithotomy for treating renal calculi in children. BJU Int 95:631–634CrossRefPubMedGoogle Scholar
  48. 48.
    Rizvi SA, Naqvi SA, Hussain Z, Hashmi A, Hussain M, Zafar MN, Sultan S, Mehdi H (2003) Management of pediatric urolithiasis in Pakistan: experience with 1, 440 children. J Urol 169:634–637CrossRefPubMedGoogle Scholar
  49. 49.
    Ritchey M, Patterson DE, Kelalis PP, Segura JW (1988) A case of pediatric ureteroscopic lasertripsy. J Urol 139:1272–1274PubMedGoogle Scholar
  50. 50.
    Schuster TG, Russell KY, Bloom DA, Koo HP, Faerber GJ (2002) Ureteroscopy for the treatment of urolithiasis in children. J Urol 167:1813, discussion 1815–1816CrossRefPubMedGoogle Scholar
  51. 51.
    De Dominicis M, Matarazzo E, Capozza N, Collura G, Caione P (2005) Retrograde ureteroscopy for distal ureteric stone removal in children. BJU Int 95:1049–1052CrossRefPubMedGoogle Scholar
  52. 52.
    Tan AHH, Al-Omar M, Denstedt JD, Razvi H (2005) Ureteroscopy for pediatric urolithiasis: an evolving first-line therapy. Urology 65:153–156CrossRefPubMedGoogle Scholar
  53. 53.
    Minevich E, Defoor W, Reddy P, Nishinaka K, Wacksman J, Sheldon C, Erhard M (2005) Ureteroscopy is safe and effective in prepubertal children. J Urol 174:276–279, discussion 279CrossRefPubMedGoogle Scholar
  54. 54.
    Van Savage JG, Palanca LG, Andersen RD, Rao GS, Slaughenhoupt BL (2000) Treatment of distal ureteral stones in children: similarities to the American Urological Association in adults. J Urol 164:1089–1093CrossRefPubMedGoogle Scholar
  55. 55.
    Lesani OA, Palmer JS (2006) Retrograde proximal rigid ureteroscopy and pyeloscopy in prepubertal children: safe and effective. J Urol 176:1570–1573CrossRefPubMedGoogle Scholar
  56. 56.
    Thomas JC, DeMarco RT, Donohoe JM, Adams MC, Brock JW 3rd, Pope JC 4th (2005) Pediatric ureteroscopic stone management. J Urol 174:1072–1074CrossRefPubMedGoogle Scholar
  57. 57.
    Cannon GM, Smaldone MC, Wu H, Bassett JC, Bellinger MF, Docimo SG, Schneck FX (2007) Ureteroscopic management of lower-pole stones in a pediatric population. J Endourol 21:1179–1182CrossRefPubMedGoogle Scholar
  58. 58.
    Tanaka ST, Makari JH, Pope JC, Adams MC, Brock JW 3rd, Thomas JC (2008) Pediatric ureteroscopic management of intrarenal calculi. J Urol 180:2150–2153, discussion 2153–2154CrossRefPubMedGoogle Scholar
  59. 59.
    Pearle MS, Lingeman JE, Leveillee R, Kuo R, Preminger GM, Nadler RB, Macaluso J, Monga M, Kumar U, Dushinski J, Albala DM, Wolf JS Jr, Assimos D, Fabrizio M, Munch LC, Nakada SY, Auge B, Honey J, Ogan K, Pattaras J, McDougall EM, Averch TD, Turk T, Pietrow P, Watkins S (2005) Prospective, randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. J Urol 173:2005–2009CrossRefPubMedGoogle Scholar
  60. 60.
    Paik ML, Resnick MI (2000) Is there a role for open stone surgery? Urol Clin North Am 27:323–331CrossRefPubMedGoogle Scholar
  61. 61.
    Zargooshi J (2001) Open stone surgery in children: is it justified in the era of minimally invasive therapies? BJU Int 88:928–931CrossRefPubMedGoogle Scholar
  62. 62.
    Casale P, Grady RW, Joyner BD, Zeltser IS, Kuo RL, Mitchell ME (2004) Transperitoneal laparoscopic pyelolithotomy after failed percutaneous access in the pediatric patient. J Urol 172:680–683, discussion 683CrossRefPubMedGoogle Scholar
  63. 63.
    Lee RS, Passerotti CC, Cendron M, Estrada CR, Borer JG, Peters CA (2007) Early results of robot assisted laparoscopic lithotomy in adolescents. J Urol 177:2306–2309, discussion 2309–2310CrossRefPubMedGoogle Scholar

Copyright information

© IPNA 2010

Authors and Affiliations

  • Michael Straub
    • 1
    • 2
    Email author
  • Jürgen Gschwend
    • 1
  • Christoph Zorn
    • 1
  1. 1.Department of UrologyTechnische Universität MünchenMünchenGermany
  2. 2.Rechts der Isar Medical Center, Department of UrologyTechnische Universität MünchenMünchenGermany

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