Treatment of pediatric urolithiasis in Iraq : five-year study

الملخص EN

Objections: To report our experience with the management of childhood urolithiasis during a 5 year period.

Methods: Between April 1999 and April 2004, 204 children with urolithiasis were prospectively evaluated, treated, and followed up in a university hospital in Baghdad.

Results: There were 150 males (73.5%) and 54 females (26.5%).

There was a history of previous stones in 73 (35.8%).

Stones were located in multiple sites in 80 children.

Metabolic disorders were present in 58 (72.5%) of those with multiple sites.

Etiology for stone formation was established in 89.7% of cases; 10.3% were idiopathic.

Metabolic disorders were detected in 147 patients (72.1%).

Recurrent urinary tract infection was present in 87 patients (42.6%).

Anatomical defects of the renal system were present in 25 patients (12.3%).

The follow up of 156 patients (76.5%) ranged from one month to 5 years (mean= 36 months).

Of those 156 patients, surgery was performed on 51.

Extracorporeal shock wave lithotripsy (ESWL) was performed in 26, medical therapy was used in 111, and 19 patients were kept on observation.

The ultimate stone free rates were 78.7%, 38.5% and 24.3% following surgery, ESWL and medical therapy respectively.

Recurrence of stone disease was 19.7% following surgery.

Respectively, 46.9% and 11.5% of patients receiving medical therapy,ESWL had no change in stone size.

Conclusion: A combined approach with one or more techniques was applied to our patients.

Our results indicate that a comprehensive approach to the care of pediatric urolithiasis requires attention to metabolic disorders.