The approach to urinary stones shows serious differences specific to children. Accurate evaluation before treatment increases the success of treatment and reduces complications.
If stone treatment is not performed properly in children, it can cause serious problems such as urinary infection and even kidney failure by obstructing the urinary system.
Calcium oxalate (50%), Calcium phosphate (20%), Infection (Struvite) (10-15%), Uric acid (7%), Cystine (5%), Mixed (4%), Xanthine (1%).
Urinary stone formation
Interaction of genetic, environmental, anatomical and chemical factors result occurs. Conditions that increase stone formation; genetics, insufficient fluid intake, nutrition, less urination, urinary infection, climatic temperature, geography, anatomical and functional urinary anomaly, foreign body (probes) in the urinary system, metabolic disorders, urinary stone-forming ion excess, urinary stone-preventing ion deficiency , urinary pH, inactivity, chronic diarrhea (malabsorption).
Diagnosis of urinary stones
Signs and findings in children are quite different from adults. Urinary stones in children may give different findings depending on their location. Sometimes the diagnosis of stone is made by chance, although the kidney is damaged, the child may not have any complaints.
Stone analysis is very important. Subsequent follow-up and preventive treatment of the patient is arranged according to the stone type.
Medical Treatment
The treatment of urinary stones shows serious differences specific to children. Accurate evaluation before treatment can increase the success of treatment and reduce complications.
An appropriate treatment should be applied to each child's needs. Anomalies and metabolic problems that form the basis of the stone should be treated.
Recurrence of urinary stones is a serious problem in children. It is very important to remove all the stones from the body. Otherwise, there is a high risk of re-stone development and the growth of small pieces in a short time.
Factors determining the type of treatment and its success
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Anatomy of the urinary system and whether there is an anomaly
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The properties of the stone: Load/size of the stone (size X number), content (y room) and location
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Child's age and gender
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Quality and variety of technical equipment
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The presence of enlargement, swelling and infection due to stones in the urinary system
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Expert's experience
Medical (Medical) Treatment
Adequate fluid intake, appropriate nutrition and drug therapy can be provided to prevent stone formation again. The most effective factor in preventing the formation and growth of stones is the amount of fluid taken.
Children should never be on a diet as they continue to grow and develop. However, animal protein, sugary and bakery products, convenience foods and fast food products should not be eaten. It should be fed mainly on vegetables and fruits.
The type of medicine to be given may differ according to the type of stone.
Surgical treatment
Thanks to the modern approach and technological developments, more than 90% of urinary stones can be treated with closed surgical methods today.
In the treatment, equipment suitable for the child and an experienced specialist in the child are of vital importance.
The frequency of re-development of the stone is a serious problem in children. Therefore, all stone fragments should always be removed during surgery. Otherwise, there is a high risk of stone development and the growth of small pieces in a short time.
Factors that increase the need for surgical treatment
Children older than 6 months, symptoms (UTI, pain) or obstruction, stones larger than 4 mm in width, multiple The presence of bilateral or bilateral stones and residual stones increase the risk of needing surgery.
Stone Breaking / ESWL
It is the process of breaking the stone by focusing and hitting the stone in the upper urinary system by shock waves created outside the body with the stone crushing device.
It is performed under general anesthesia and radiation. More than one session may be required, and therefore general anesthesia and radiation many times.
Is the doctor's surgical experience important?
The kidneys in children are small and very mobile. The ureters are thin and the wall is weak. For this reason, those who are not familiar with the urinary system anatomy and development of children, who are not familiar with pediatric interventions and who are competent in endoscopic stone surgery. If stone removal is attempted by physicians who do not have sufficient experience, life-threatening complications may occur.
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