Endemic Vesical Stones in Sudanese Children Seen at Gezira National Center for Pediatric Surgery (original) (raw)
Related papers
2011
BACKGROUND: Stone in the bladder is an uncommon presentation in the tropics, especially in children. Its rarity makes the index of suspicion to be low. Patients presenting with it may be mistaken for urinary tract infection (UTI) because of the presence of frequency and dysuria. OBJECTIVE: To present a rare cause of urinary bladder stone in a child in the tropics. METHODS: The patient, a three-year-old boy, presented with recurrent episodes of dysuria and stragury for a duration of about one year. Work up included clinical evaluation and laboratory assessments, results of which informed surgical intervention. RESULTS: The child had been treated repeatedly for urinary tract infection. He was acutely ill with suprapubic tenderness dysuria and poor urinary stream. He was hypertensive. Micturating cystourethrography showed posterior urethral valves and a bladder stone. He had vesicolithotomy and valvotomy with improvement of his blood pressure. CONCLUSION: The coexistence of bladder stone with PUV coupled with delayed diagnosis may be a predisposing factor to hypertension in children. Conventional surgical treatment gives good results. WAJM 2011; 30(3): 214-216.
INCIDENCE OF PEDIATRIC URINARY STONES IN ORPHANAGE CHILDREN IN PEKANBARU, RIAU PROVINCE OF INDONESIA
National Journal of Medical Research, 2018
Introduction: Urinary stones are seldom in children. Currently the incidence of urinary stones in children increases three time folds in the last third decade and occurs in the first decade of life. Objectives: The aim of this study is to identify the incidence of pediatric urinary tones in orphanage children. Materials and Methods: We examined urinary stones by using ultrasound in orphanage children of two orphanages in Pekanbaru, Riau Province, Indonesia. Univariate test was used for statistical analysis. Approval on the study was obtained from the Ethical Review Board for Medicine and Health Research, Medical Faculty, University of Riau. Results: There were 88 orphanage children in the study in which orphanage girls were more (54,5%) than the boys (45.5%), 13 – 15 age group was the most (34.1%) and the least (4.5%)was 4 – 5 age group. The most symptom was flank pain (11.4%), followed by voiding pain (dysuria) (5.7%), bloody urine (hematuria) (5.4%), spontaneously passing stone (2.3%), urinary stone history (1.3%) and family urinary stone history (1.3%). There was no positive result of urinary stone in urologic physical examinations. In all orphanage children, there was no urinary stones found in ultrasound examinations but there were 23.9 of cystitis, less simple kidney cyst and kidney hypoplasia. Conclusions: Although we found several symptoms and signs of urinary stone but in all orphanage children, there was no urinary stones found in ultrasound examinations but there were 23.9% of cystitis.
2014
Objective: Vesical stones may be associated with significant urological symptoms and may reflect more serious underlying urological or systemic problems. The aim of this study is to discuss the trends of vesical stones in women, diagnostic tools, and their management patterns. Patients & methods: A cross-spective study of 25 female patients, presented with vesical stones, from the urology department at AlJumhoori teaching hospital in Mosul. History, physical examination, laboratory & radiological investigations were performed trying to confirm the diagnosis & look for any possible underlying etiology. Then the treatment modality( open surgery versus endoscopic intervention ) was decided with regard to stone(s) size, number, the patients age & facilities available in the center. The results were analyzed accordingly. Results: The mean patients age is 31.2 years. They presented with a mix of symptoms that mainly included irritative voiding symptoms, suprapubic pain, & hematuria. Ultra...
Nigerian Journal of Surgical Research, 2006
Urinary stones were previously thought to be uncommon in the paediatric age however this may be due to differences in presentation and evaluation of children with stones. There are variations in the incidence worldwide; affected by diet and climate. Common aetiological factors are metabolic changes, urinary tract abnormality and urinary tract infections. The patho-physiological processes leading to stone formation are multifactorial involving interplay of increasing concentration of particles in urine, such as calcium, magnesium, phosphates, oxalates, alteration in urine pH and a decrease in the flow of urine or stasis. Presentation may be acute or non-specific and varied thus diagnosis is often difficult or delayed and a wide range of imaging techniques, urine and serum biochemical analysis are needed for evaluation. Treatment must also be directed towards removing the underlying cause(s) of the stone where this is identified as well as dealing with the pathological affects of the stone if recurrence is to be minimized.
Approach and Medical Management of Urinary Tract Stone in Children
Caspian Journal of Pediatrics (CJP), 2016
Kidney stone disease has become more common in children, but it remains non diagnosed in a significant proportion of patients, due to a lack of notable signs and symptoms. All children with colicky abdominal pain or microscopic hematuria should be examined thoroughly for urolithiasis. Patients' histories in terms of family, medical, and drug and a thorough physical examination are required to be considered during diagnostic evaluation. Thereafter, diagnostic imaging methods should be aimed to detect the size, shape and location of calculi and also urinary tract anomalies. Ultrasound should be used as the initial imaging method to evaluate children with suspected nephrolithiasis. The noncontrast computerized tomography reserved for those in whom ultrasound is unable to diagnose stone. Increased water and fluid intake and a reduction of salt consumption are the common recommendation to those children with a history of kidney stones, though the rate of stone recurrence in children is unknown. Since metabolic disorders are the most frequent causes of stone in children, diagnostic evaluation should also target the detection of metabolic disorders including hypercalciuria, hyperoxaluria, hyperuricosuria and so on that may cause recurrent nephrolithiasis. Kidney stone is not a disease itself, but it is only a symptom. Therefore, its early diagnosis is mandatory for every child with the first stone event. In this article, we have summarized literature and emphasize that a few studies with acceptable quality are available on children with urolithiasis in Iran and the world that warrant future studies on this topic.
Etiological Evaluation in Pediatric Urinary Stone Disease
Çukurova anestezi ve cerrahi bilimler dergisi, 2023
Aim: Urinary stone disease is an important health problem commonly seen in some regions of the world. Determining the etiology is important for effective treatment and prevention of recurrence. The aim of this study was to evaluate the demographic and clinical features, metabolic and other risk factors of children with urinary stone disease. Methods: A total of 766 patients with urinary stone disease presented to our pediatric nephrology department over 15 years. The patients' demographic, clinical, and treatment data were retrospectively analyzed. Results: The mean age at diagnosis was 61.6±52.7 months. The male/female ratio was 1.15:1. There was no significant difference in age at diagnosis between the sexes. The most frequent presenting complaint overall was abdominal pain. Chronic renal failure was present in 1.8% and family history in 57.5% of the patients. Metabolic abnormalities were detected in 51% of the patients, urinary tract infection in 44.8%, and urinary tract anomalies in 13.2%. No cause could be identified in the other 22.7% of the patients. Urinary tract infection was the most common etiology in patients younger than 1 year old, while metabolic risk factors were more frequent in patients aged 1-10 years. Metabolic abnormalities included hypercalciuria (51.7%), hypocitraturia (47.5%), hyperoxaluria (39.9%), hyperuricosuria (23.4%), and cystinuria (9.4%). Bilateral and multiple stones were associated with metabolic abnormalities (p<0.001 and p=0.011). Nearly all stones (96.5%) were located in upper urinary tract and 1.8% were in the bladder. Calcium oxalate was the most common type of stone (61.7%). In terms of treatment, 32.5% of patients received medical treatment, 7.9% underwent extracorporeal shock-wave lithotripsy, and 14.3% had surgery. During follow-up, 30.1% of patients exhibited complete resolution and the other 69.9% had persistent disease. Conclusions: Urinary stone disease is an important health problem in childhood and requires a thorough evaluation of metabolic risk factors to clarify the etiology. Treating metabolic and structural abnormalities and controlling urinary tract infection are important to protect renal function and prevent recurrence.
2014
Background:-Urolithiasis in the pediatric age group plays an important urologic problem, not only in parts of the world with a high incidence of stone disease such as the near and Far East, but also in the developing and industrialized countries. Pediatric urolithiasis is associated with significant morbidity, particularly recurrent stones as well as the development and progression of renal dysfunction, thus, should not be underestimated. This study will assess the prevalence and risk factors for urolithiasis in children in a tertiary teaching hospital. Objectives: To assesses the prevalence and risk factors of urolithiasis, in children whose age is less than 14 years in Tikur Anbessa Specialized Teaching Hospital. Materials and methods: This is a retrospective cohort study conducted in admitted patients with the diagnosis of urolithiasis in Tikur Anbessa Specialized Teaching Hospital over an eight year period from 2002 to 2010 GC. Data was collected from the records of patients. Result: A total of 63 children with urolithiasis were admitted to Tikur Anbessa Specialized Teaching Hospital over an eight year period. This accounts to 1 in 121 (0.83%) pediatric surgical ward admissions annually. Among those half of the patients (54%) were in the age range between 5-10 years and 85.7% were males. The major clinical symptoms at first presentation were hematuria (63.5%) recurrent urinary tract infection (60.3%), obstructive symptoms (46.0%), flank pain (42.9%) and family history of urolithiasis was preset in (3.2%). Urine culture was done for 38.1% of the children and 25% of them were positive for E.coli or Klebsiella pneumoniae. Pyuria was present in 47.6% of children. All the stones were visualized by ultrasound, almost half of the stones were found in the kidneys (53.9%) and bladder (39.7%). Ureteric stones constituted 6.3%. Sixty six point seven percent of the stones were removed surgically and 19.0% passed spontaneously. Extracorporeal Shock Wave Lithotripsy (ECSWL) was used in 14.3% of children. Stone analysis result was found in 15/63 (23.8%) children and Calcium oxalate was the commonest stone constituting 40%, uric acid 13.3%, calcium oxalate and uric acid(20%),and 26.6% were more than 2 types (mixed) stones. There was recurrence of stone in 9.5% of children and 50% recurred after one year of follow up. Conclusion: Even though the prevalence of urolithiasis in children is low it is not uncommon to see complications like recurrence and renal insufficiency. Any child who presents with hematuria and recurrent urinary tract infection, stone disease has to be ruled out. All stones have to be analyzed and children with stone disease have to be followed even after removal.
Management of impacted urethral stones in children
To find out the clinical presentation, site of impaction, management and outcome of children presenting with urinary retention due to urethral stone. Case series. Surgical Unit B of National Institute of Child Health (NICH), Karachi, from April 2009 to January 2010. All the patients under the age of 12 years, who presented with urinary retention due to impacted urethral stones were included. Urinary retention due to other causes like trauma, stricture, pelvic masses etc. were excluded. Diagnosis was made on clinical examination (palpable stone in penile urethra) and with the help of radiology. Surgical procedure was tailored according to the site of impaction in urethra. All stones were sent for chemical analysis and patients were followed in Nephrology OPD (stone clinic) for further work-up. There were a total of 19 patients with mean age of 3.94 ± 2.27 years. All were males. Twelve patients (63.1%) had stones impacted in anterior urethra while 7 (36.9%) were found in posterior ure...
European Urology Focus, 2021
Context: Paediatric stone disease is an important clinically entity and management is often challenging. Although it is known that the condition is endemic in some geographic regions of the world, the global incidence is also increasing. Patient age and sex; the number, size, location, and composition of the stone; and the anatomy of the urinary tract are factors that need to be taken into consideration when choosing a treatment modality. Objective: To provide a general insight into the evaluation and management of urolithiasis in the paediatric population in the era of minimally invasive surgery. Evidence acquisition: A nonsystematic review of the literature on management of paediatric urolithiasis was conducted with the aim of presenting the most suitable treatment modality for different scenarios. Evidence synthesis: Because of high recurrence rates, open surgical intervention is not the first option for paediatric stone disease, except for very young patients with very large stones in association with congenital abnormalities. Minimally invasive surgeries have become the first option with the availability of appropriately sized instruments and accumulating experience. Extracorporeal shockwave lithotripsy (SWL) is noninvasive and can be carried out as an outpatient procedure under sedation, and is the initial choice for management of smaller stones. However, for larger stones, SWL has lower stone-free rates and higher retreatment rates, so minimally invasive endourology procedures such as percutaneous nephrolithotomy and retrograde intrarenal surgery are preferred treatment options. Conclusions: Contemporary surgical treatment for paediatric urolithiasis typically uses minimally invasive modalities. Open surgery is very rarely indicated. Patient summary: Cases of urinary stones in children are increasing. Minimally invasive surgery can achieve high stone-free rates with low complication rates. After stone removal, metabolic evaluation is strongly recommended so that medical treatment for any underlying metabolic abnormality can be given. Regular follow-up with imaging such as ultrasound is required because of the high recurrence rates.
Curēus, 2024
This study reviews the challenges and management strategies for complex renal stones in Africa. Historically viewed as infection or struvite stones, recent studies highlight diverse compositions of staghorn stones. These complex stones pose significant risks, including recurrent urinary tract infections and renal impairment. In the past, conservative management of staghorn stones was associated with high morbidity; thus, surgical intervention was necessary for complete eradication. While percutaneous nephrolithotomy (PCNL) remains the standard, it carries notable risks, leading to a shift towards minimally invasive techniques. This study reviews challenges and management practices for complex renal stones and staghorn calculi in African countries, evaluating stone-free rates and associated complications. A scoping review of the literature, following the Preferred Reporting Items for Systematic Reviews and Metaanalysis guidelines, was performed. A systematic search was conducted in PubMed, African Journal Online (AJOL) and Google Scholar, yielding 1,101 articles, but only 11 articles satisfied the inclusion criteria. The study included 1,513 patients with 1,582 renal units, predominantly male (67.2%) with an average age of 40.7 years. Percutaneous nephrolithotomy (PCNL) was the primary treatment for the majority (71.3%), followed by open surgery (21.9%), laparoscopic surgery (4.1%), and retrograde intrarenal surgery (RIRS) (2.7%). The stone clearance rates for PCNL, open surgery, laparoscopic pyelolithotomy, and RIRS were 82.8%, 83.7%, 100%, and 92.8%, respectively. Stone sizes ranged between 22 and 80 mm, with 66% being staghorn stones. Complication rates were highest for open surgery (30.8%) and lowest for RIRS (4.7%). Despite PCNL being the global standard, African studies still indicate a high reliance on open surgery, likely due to healthcare infrastructure, resource availability and socioeconomic factors. Enhancing access to urological care and addressing healthcare disparities are imperative for improving staghorn stone management in Africa.