Imaging modalities and treatment of paediatric upper tract urolithiasis: A systematic review and update on behalf of the EAU urolithiasis guidelines panel

Grivas, Nikolaos; Thomas, Kay; Drake, Tamsin; Donaldson, James F.; Neisius, Andreas; Petřík, Aleš; Ruhayel, Yasir; Seitz, Christian; Türk, Christian; Skolarikos, Andreas

doi:10.1016/j.jpurol.2020.07.003

Cited by 34 publications

(37 citation statements)

References 107 publications

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“…In our unit, we use a holmium YAG laser that has proven itself particularly beneficial for flexible ureteroscopy. Moreover, it is advocated as the current gold standard for laser lithotripsy according to the European urology guidelines 24 . Widely demonstrated advantages of its usage are appropriate fragmentation of all known urinary stone types, capability to operate with small and flexible fibres (core diameters as thin as 200 um), an acceptable safety profile due to limited energy losses, and reduced tissue penetration, lowering the risk of collateral tissue damage 25 …”

Section: Discussionmentioning

confidence: 99%

Combined treatment of ureteropelvic junction obstruction and renal calculi with robot‐assisted laparoscopic pyeloplasty and laser lithotripsy in children: Case report and non‐systematic review of the literature

Scarcella

Tiroli

Torino

et al. 2021

Robotics Computer Surgery

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Objective(s) The incidence of urinary tract stone disease is steadily increasing in both adult and paediatric populations. This condition develops due to different factors: dietary or metabolic alterations, infection, and congenital anatomic malformations. Standard indications and treatments for children are analogous to the ones indicated for adults. Extracorporeal shock wave lithotripsy, ureterorenoscopy and percutaneous nephrolithotomy (PCNL) should be preferred to more invasive techniques. Moreover, the introduction of laparoscopic and robot‐assisted laparoscopic approaches have improved surgical outcomes, lowering the bleeding risk with higher stone‐free rates, even in complicated cases. Despite these well‐known improvements, there are few reports regarding laparoscopic robot‐assisted management for urinary tract stone disease in paediatric patients under the age of 10, especially with concomitant treatment of ureteropelvic junction obstruction and multiple calyceal stones. Patient and Method(s) A 4‐year‐old child was referred for recurrent right abdominal flank pain, macroscopic haematuria and a previous history of urinary tract infections. A computed tomography of the abdomen showed right ureteropelvic junction obstruction associated with multiple unilateral stones located in the renal pelvis and in the interpolar renal calyces. Due to its complexity, we held a multidisciplinary meeting with paediatric surgeons and nephrologists to determine optimal treatment. As a result, a combined robot‐assisted laparoscopic pyeloplasty (LP) and renal calculi holmium laser lithotripsy using a digital flexible ureteroscope through an abdominal robotic trocar was performed. No post‐surgical complications were recorded, and the patient was discharged within 48 h following surgery. At subsequent regular follow‐up examinations over a period of 24 months, no signs of recurrence were detected for both ureteropelvic junction obstruction and stone disease. Result(s) Robot‐assisted LP with concomitant laser lithotripsy is a reasonable treatment option for designated young paediatric patients with challenging ureteropelvic junction obstruction complicated by urolithiasis, especially in cases where stones are not amenable with standard procedures.

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Section: Discussionmentioning

confidence: 99%

Combined treatment of ureteropelvic junction obstruction and renal calculi with robot‐assisted laparoscopic pyeloplasty and laser lithotripsy in children: Case report and non‐systematic review of the literature

Scarcella

Tiroli

Torino

et al. 2021

Robotics Computer Surgery

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“…In adults, treatment options include watchful waiting, extracorporeal shock wave lithotripsy, ureterorenoscopy, percutaneous nephrolithotomy, and open removal. In children, however, extracorporeal shock wave lithotripsy and minimal invasive procedures utilizing smaller diameter scopes are preferred [7]. Prophylactic treatment to prevent recurrence depends upon identification of metabolic abnormalities among those at risk.…”

Section: Introductionmentioning

confidence: 99%

Frequency of Metabolic Abnormalities in Pakistani Children With Renal Stones

Sajid

Zafar

Mustafa

et al. 2021

Société Internationale D’Urologie Journal

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Objective: To determine the frequency of various metabolic abnormalities in children with urinary lithiasis. Methods: This cross-sectional study was conducted at the Armed Forces Institute of Urology, Rawalpindi, from 30 January 2017 to 1 February 2020. A total of 1355 children who were aged 4 to 14 years and who had renal stones were included, while those with urinary tract infections, posterior urethral valve, pelvi-ureteric junction obstruction, reflux disease, and chronic renal failure were excluded. Twenty-four-hour urine samples were analyzed for urinary uric acid, calcium, oxalate, citrate, and magnesium. Demographics and metabolic abnormalities—hypercalciuria, hyperoxaluria, hypocitraturia, hyperuricosuria, and hypomagnesuria—were noted and analyzed. Results: The study analysis included 1355 patients. Low urine volume was observed in 465 (34.3%) of the patients. Three hundred nine patients (22.8%) had metabolic abnormalities, the most common being hypocitraturia (184, 59.5%) followed by hypercalciuria (136, 44%) and hypomagnesuria (126, 40.8%). Mean age of presentation, disease duration, recurrent bilateral stones were found significantly different in those having metabolic abnormalities (7.81±2.25 versus 8.76±2.50 P < 0.001, 7.73±1.50 versus 8.43±1.54 P < 0.001, 19.4 versus 2.4% P < 0.001 respectively). No significant difference was found in frequency of abnormal urinary metabolic parameters between boys and girls (P > 0.05) or, upon data stratification, on the basis of disease duration, stone laterality, and recurrence. Conclusion: Metabolic abnormalities were found in 22.8% % of children presenting with urinary lithiasis. The most frequent abnormality observed was hypocitraturia followed by hypercalciuria and hypomagnesuria. Early identification helps manage such patients appropriately, mitigating long-term sequelae.

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“…Fakat ESWL başarısını etkileyen birçok faktör bulunmaktadır. Bunlar taşın boyutu, lokalizasyonu, bileşenleri, üriner sistem anatomisi, Vücut Kitle İndeksi (VKİ), taş cilt mesafesi ve ESWL ekipmanı olarak bildirilmiştir (8)(9)(10)(11). Ayaktan uygulanabilirliği, sedoaneljezinin yeterliliği, tekrarlanabilir oluşu ve diğer tedavi seçeneklerine kıyasla daha az invaziv oluşu önemli avantajlarıdır (12).…”

Section: Introductionunclassified

Pediatrik Ürolitiyazis Tedavisinde Beden Dışı Şok Dalga Litotripsi (ESWL) Sonuçlarımız: Tek Merkez Deneyimi

Yağmur

Demir

Kati

et al. 2021

Harran Üniversitesi Tıp Fakültesi Dergisi

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Bu çalışmada amacımız ürolitiyazis nedeniyle ESWL uyguladığımız çocukların tedavi sonuçlarını değerlendirmektir. Materyal ve metod: Ekim 2018-Ekim 2020 tarihleri arasında anestezi altında ESWL uygulanan çocukların kayıtları retrospektif olarak incelendi. Hastalar ESWL başarısına göre iki gruba ayrılarak yaş, cinsiyet, taş boyutu, taş lokalizasyonu, komplikasyonlar ve ek müdahaleler açısından karşılaştırıldı. Bulgular: Çalışmaya dahil edilen 50 olgunun 34(%68)'ü erkek, 16(%32)'sı kız idi. Hastaların ortalama yaşı 8,8±5,0 yıl idi. Taşların 29'u sağ, 21'i sol taraftaydı. Taşların 36'sı böbrek, 14'ü ise proksimal üreter yerleşimliydi. ESWL başarılı grupta taş boyutu ortalama 9.4±1.8 mm, başarısız grupta ise 13.8±3.2 mm olarak saptandı(p<0.05). 10 mm'nin altındaki taşlarda ESWL başarısı %90 iken, 10 mm üzerindeki taşlarda %56.7 olarak bulundu(p<0,05). Toplam başarı % 70 idi. Yaş, cinsiyet, taşların tarafı ve lokalizasyonları ile ESWL başarısı arasında anlamlı bir ilişki bulunmadı (p>0,05). İki hastada taş yolu, 1 hastada üriner enfeksiyon ve 5 hastada geçici hematüri görüldü. Sonuç: Ürolitiyazisli çocuklarda ESWL etkili ve güvenli bir tedavi yöntemidir. Taş boyutu başarıyı etkileyen önemli bir faktördür. Özellikle ≥10 mm taşlarda, seans başına maksimum yararlanmayı sağlayacak ve başarısız bir uygulamanın önüne geçebilecek öngörüyü ortaya çıkaracak çalışmalara ihtiyaç vardır.

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Imaging modalities and treatment of paediatric upper tract urolithiasis: A systematic review and update on behalf of the EAU urolithiasis guidelines panel

Cited by 34 publications

References 107 publications

Combined treatment of ureteropelvic junction obstruction and renal calculi with robot‐assisted laparoscopic pyeloplasty and laser lithotripsy in children: Case report and non‐systematic review of the literature

Combined treatment of ureteropelvic junction obstruction and renal calculi with robot‐assisted laparoscopic pyeloplasty and laser lithotripsy in children: Case report and non‐systematic review of the literature

Frequency of Metabolic Abnormalities in Pakistani Children With Renal Stones

Pediatrik Ürolitiyazis Tedavisinde Beden Dışı Şok Dalga Litotripsi (ESWL) Sonuçlarımız: Tek Merkez Deneyimi

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