Lasorsa F. et al., 2023: Management of Pediatric Urolithiasis in an Italian Tertiary Referral Center: A Retrospective Analysis.
Lasorsa F, Caliolo C, Silecchia A, Laricchiuta N, Raguso M, Ditonno P, Lucarelli G.
Department of Precision and Regenerative Medicine and Ionian Area-Urology, Andrology and Kidney Transplantation Unit, University of Bari "Aldo Moro", 70124 Bari, Italy.
Urologic Pediatric Surgery Unit, Pediatric Hospital "Giovanni XXIII", 70124 Bari, Italy.
Abstract
Background and Objectives: In recent years, the prevalence of pediatric urolithiasis has increased in North America and Western countries, though it is endemic in developing countries. The aim of this study is to describe the experience of a tertiary pediatric referral center in the surgical management of pediatric urolithiasis. Materials and Methods: We retrospectively reviewed the experience of patients ≤ 16 years old affected by urinary stones who underwent surgery. Results: From April 2021 to September 2023, 31 pediatric patients underwent surgical procedures for stone diseases at our department: 13 preschool-aged (1-5 years) and 18 school-aged (6-16 years) children. During this period, 12 URSs, 17 RIRSs, and 2 PCNLs were recorded. Five patients had residual fragments at first, so three of them underwent a second endourological lithotripsy (2 RIRSs and 1 URS). Complete clearance was finally achieved in 27 patients. The stone composition was evaluated in 25 cases. Conclusions: Numerous innovations in the surgical treatment of pediatric urolithiasis have resulted from the development of smaller devices and new technology. Our results show how, in experienced centers, retrograde and percutaneous lithotripsy are safe and effective procedures for use in pediatric populations.
Medicina (Kaunas). 2023 Dec 14;59(12):2165. doi: 10.3390/medicina59122165. PMID: 38138268 FREE ARTICLE
Comments 1
This article presents a summary of how stones in 31 children up to 16 years were treated over a 30 months’ period.
It is of note that none of the children was treated with non-invasive SWL even though as many as 12 children had their stones in the ureter and that the stone size was in average 10 mm (7-12).
Treatments were as follows:
URS 12
RIRS 17
PCNL 2
Most certainly some of these children might have been successfully treated non-invasively with SWL but my suspicion is that SWL was unavailable in this center.
Hans-Göran Tiselius