Minimally invasive techniques used for treatment of urolithiasis in children
1 Department of Paediatric Surgery and Urology, Medical Centre for Postgraduate Education, Paediatric Hospital in Dziekanów Leśny, Dziekanów Leśny, Poland. Head of the Department: Associate Professor Beata Jurkiewicz, MD, PhD
2 Department of Imaging, Paediatric Hospital in Dziekanów Leśny, Dziekanów Leśny, Poland. Head of the Department: Maria Uliasz, MD, PhD
Correspondence: Joanna Samotyjek, Department of Paediatric Surgery and Urology, Medical Centre for Postgraduate Education, Paediatric Hospital in Dziekanów Leśny, Marii Konopnickiej 65, 05-092 Łomianki, Poland, tel.: +48 22 765 72 54, e-mail: asiamed@poczta.onet.pl
Pediatr Med Rodz 2019, 15 (1), p. 42–46
DOI: 10.15557/PiMR.2019.0008
ABSTRACT

The paediatric population is a special group among patients with urolithiasis. Within the past 25 years, the prevalence of this disease in the paediatric population has increased from 6% to 10%. The causes of this higher prevalence are not entirely clear but may be associated with various factors, such as: inappropriate eating habits, inappropriate diet, particularly rich in salt and animal protein, insufficient fluid intake, obesity, hypertension, pollution, faster pace of living as well as uncontrolled intake of multivitamin preparations and dietary supplements. The mean age of a paediatric patient with urolithiasis is 7–8 years. The aim of this publication is to present minimally invasive techniques used for treatment of urolithiasis in the paediatric population. Due to a high risk of disease recurrence, the selection of a treatment method that enables removal of calculi in the least invasive and the most effective way is vital in this group of patients. The choice of management depends on various factors, such as: location, size and composition of calculi, patient’s age, anatomical conditions, the degree of urinary outflow obstruction and recurring urinary tract infections. Surgical methods of urolithiasis treatment are identical in adults and in children. Minimally invasive techniques include extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopic lithotripsy (URSL; ureterolithotripsy) and retrograde intrarenal surgery (RIRS). Owing to the technical advancement, minimally invasive techniques are effective in children and help evacuate calculi fully, even with a single procedure. It must be remembered, however, that they should be performed by experienced urologists in highly specialised and well-equipped centres.

Keywords: urolithiasis, children, ESWL, PCNL, URSL, RIRS