Composition of urinary calculi in infants: a report from an endemic country

Zafar, Mirza Naqi; Ayub, Salma; Tanwri, Hafsa; Naqvi, Syed Arsalan Ahmed; Rizvi, Syed Adibul Hasan

doi:10.1007/s00240-017-1010-1

Cited by 12 publications

(3 citation statements)

References 29 publications

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“…Urolithiasis in childhood is rare in the developed world, and bladder stones (BS) represent 1 to 5% of all urinary tract stones (1)(2)(3)(4). In developed countries the main components of BS are struvite or calcium oxalate dihydrate, while in developing countries the main component is ammonium acid urate (5)(6)(7). In the last few years, transurethral lithotripsy has become an alternative method to open cystolithotomy (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Management of Bladder Stones in Children

et al. 2021

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Background: Bladder stones (BS) are rare in children. Minimally invasive surgery (MIS) seems to be nowadays the procedure of choice to treat pediatric patients with BS. This study aimed to analyze retrospectively our experience with percutaneous cystolithotomy, endourological treatment with Holmium laser and robotic cystolithotomy in children with BS.Methods: We retrospectively analyzed the data of 13 children (eight boys and five girls) with BS who were treated at our centers between July 2013 and July 2020. The patients received three different MIS procedures for stones removal: five underwent robotic cystolithotomy, five underwent endourological treatment and three received percutaneous cystolithotomy (PCCL). We preferentially adopted endourological approach for stones <10 mm, percutaneous approach between 2014 and 2016 and robotic approach since 2016 for larger stones.Results: Mean patients' age at the time of diagnosis was 13 years (range 5–18). Ten/13 patients (76.9%) had primary BS and 3/13 patients (23.1%) had secondary BS. Mean stone size was 18.8 mm (range 7–50). In all cases the stones were removed successfully. One Clavien II post-operative complication occurred following PCCL (33.3%). All the procedures were completed without conversions. Operative time ranged between 40 and 90 min (mean 66) with no significant difference between the three methods (p = 0.8). Indwelling bladder catheter duration was significantly longer after PCCL (mean 72 h) compared with robotic and endourological approaches (mean 15.6 h) (p = 0.001). Hospitalization was significantly longer after PCCL (mean 7.6 days) compared with the other two approaches (mean 4.7 days) (p = 0.001). The endourological approach was the most cost-effective method compared with the other two approaches (p = 0.001).Conclusions: Minimally invasive management of bladder stones in children was safe and effective. Endourological management was the most cost-effective method, allowing a shorter hospital stay compared with the other procedures but it was mainly indicated for smaller stones with a diameter < 10 mm. Based upon our preliminary results, robotic surgery seemed to be a feasible treatment option for BS larger than 15–20 mm. It allowed to remove the big stones without crushing them with a safe and easy closure of the bladder wall thanks to the easy suturing provided by the Robot technology.

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Section: Introductionmentioning

confidence: 99%

Minimally Invasive Management of Bladder Stones in Children

et al. 2021

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“…En el caso de la xantina, el porcentaje de cálculos hallados con este componente en población general coincidió con lo reportado en Turquía (28) , pero en población pediátrica fue menor a lo descrito en Pakistán (29) .…”

Section: Colaboración De Los Autoresunclassified

Genetic lithiasis: the contribution of infrared spectroscopy as a diagnostic tool

Giménez

Funes

Granado

et al. 2022

Rev. salud publica Parag

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Lithiasis of genetic origin is caused by rare hereditary pathologies, in which the accumulation of compounds in urine is associated with the formation of recurrent urinary stones, generating detrimental consequences for the patient. Fourier transform infrared spectroscopy (FTIR) is a reference methodology in the analysis and unambiguous identification of compounds present in urinary calculi. The aim of this study was to describe the use of the FTIR technique and its importance as a diagnostic tool for genetic lithiasis in Paraguay. The design was observational descriptive and was analyzed by FTIR urinary stones from 740 patients with demographic and clinical data. Of the total, 104 were children and 636 adults. Stones related to genetic pathologies were identified in 7 (0,9%) patients, 5 of cystine and 2 of xanthine, allowing the definitive diagnosis of cystinuria and xanthinuria, respectively. The most common location of the stones was the kidney, the most frequent form of removal was surgery and the largest had 24x19x13 mm, considered as voluminous. Were submitted stones of the first episode of 5 patients and recurrence of 2 patients. The accurate diagnosis of these genetic lithiases was possible by means of the FTIR technique, which allowed knowledge of the underlying cause and to guide the choice of specific therapeutic measures aimed at decreasing the risk of recurrence and to improve the standard of living of patients.

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“…Ammonium urate stones are rare in economically developed areas, accounting for 0.38-8.7%, [13][14][15][16][17][18][19] while they are common in economically underdeveloped areas, accounting for over 28.2%. [20][21][22][23] The physicochemical properties of uric acid and ammonium urate stones are very different. Uric acid stones are non-infected stones that are formed when urine pH is less than 5.5.…”

Section: Introductionmentioning

confidence: 99%

Development of a radiomics model to discriminate ammonium urate stones from uric acid stones in vivo: A remedy for the diagnostic pitfall of dual-energy computed tomography

Zheng,

Zhang,

Cai

et al. 2023

Chinese Medical Journal

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Background: Dual-energy computed tomography (DECT) is purported to accurately distinguish uric acid stones from non-uric acid stones. However, whether DECT can accurately discriminate ammonium urate stones from uric acid stones remains unknown. Therefore, we aimed to explore whether they can be accurately identified by DECT and to develop a radiomics model to assist in distinguishing them. Methods: This research included two steps. For the first purpose to evaluate the accuracy of DECT in the diagnosis of uric acid stones, 178 urolithiasis patients who underwent preoperative DECT between September 2016 and December 2019 were enrolled. For model construction, 93, 40, and 109 eligible urolithiasis patients treated between February 2013 and October 2022 were assigned to the training, internal validation, and external validation sets, respectively. Radiomics features were extracted from non-contrast CT images, and the least absolute shrinkage and selection operator (LASSO) algorithm was used to develop a radiomics signature. Then, a radiomics model incorporating the radiomics signature and clinical predictors was constructed. The performance of the model (discrimination, calibration, and clinical usefulness) was evaluated. Results: When patients with ammonium urate stones were included in the analysis, the accuracy of DECT in the diagnosis of uric acid stones was significantly decreased. Sixty-two percent of ammonium urate stones were mistakenly diagnosed as uric acid stones by DECT. A radiomics model incorporating the radiomics signature, urine pH value, and urine white blood cell count was constructed. The model achieved good calibration and discrimination {area under the receiver operating characteristic curve (AUC; 95% confidence interval [CI]), 0.944 (0.899–0.989)}, which was internally and externally validated with AUCs of 0.895 (95% CI, 0.796–0.995) and 0.870 (95% CI, 0.769–0.972), respectively. Decision curve analysis revealed the clinical usefulness of the model. Conclusions: DECT cannot accurately differentiate ammonium urate stones from uric acid stones. Our proposed radiomics model can serve as a complementary diagnostic tool for distinguishing them in vivo.

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Composition of urinary calculi in infants: a report from an endemic country

Cited by 12 publications

References 29 publications

Minimally Invasive Management of Bladder Stones in Children

Minimally Invasive Management of Bladder Stones in Children

Genetic lithiasis: the contribution of infrared spectroscopy as a diagnostic tool

Development of a radiomics model to discriminate ammonium urate stones from uric acid stones in vivo: A remedy for the diagnostic pitfall of dual-energy computed tomography

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