What are the age ranges of children with kidney stones and who are the risk groups?
- Percutaneous Surgery in Children
- Urological Diseases
- Prostate Enlargement
- Kidney Stones
- Urological Cancers
- Urinary Tract Stenosis
- Kidney Stone Treatment in Children
- Kidney Stone Treatments
- Percutaneous kidney surgery
- Ureteroscopic interventions
- Shock wave therapy (SWL)
- Open kidney surgeries
- Foods eaten and drunk,
- Infection that cannot be treated properly,
- There are some anatomical structural changes of the urinary tract,
- The presence of stone disease in the family, that is, a genetic predisposition,
- There are some metabolic disorders.
- In recent years, it has become more common. One of the reasons why it is seen is that imaging methods have improved and more detailed images can be obtained.
What are the age ranges of children with kidney stones and who are the risk groups?
Stone disease in children can be seen in all age groups, including babies. There may even be babies under the age of one who are diagnosed with stones and need treatment. It is known that stone disease in children has increased in recent years. It has been determined that stone disease in children has increased 4-5 times, especially since the late 1900s. These may have different reasons. It has been determined that this increase is especially higher in girls.
What are the Reasons for the Increase in Kidney Stone Formation in Children?
There may be different reasons for the formation of kidney stones in children.
Primary among these;
What Should Be Done to Prevent Kidney Stone Formation?
It is not possible to completely prevent kidney stone formation. However, if there are modifiable risk factors, identifying them and planning treatments for them will at least reduce the possibility of new stone formation as much as possible. For example; If there is a metabolic disorder, it may be necessary to start a treatment for it.
İ If there are some structural defects in the urinary tract that will facilitate the formation of stones, that is, stenosis and widening that make the flow of urine difficult, or areas where urine pools and increase stone formation, surgical correction of these will reduce the possibility of stone formation as much as possible.
Apart from this, especially Effective planning of treatments for recurrent and poorly treated urinary tract infections, which are more common in girls, greatly reduces stone formation.
What are the Symptoms of Kidney Stones in Children?
Diagnosing a child who has a stone, who passes a stone, or who has problems due to a stone is different from that of adults. Adults who pass stones often experience nausea and vomiting along with severe side pain. Since the pain is in the kidney area, the patient already thinks about a problem in the kidney.
The situation is slightly different in children. As age decreases, more variable findings may occur. However, stone problems in children often manifest themselves with abdominal pain. Sometimes nausea and vomiting may occur. Abdominal pain, loss of appetite, and the child turning yellow and pale should be suspicious for stones.
When investigations are carried out, problems such as the presence of stones may be revealed. One in every five children may have a stone problem without any symptoms.
Why Is Early Diagnosis of Kidney Stones in Children Very Important?
Early diagnosis of kidney stones. Diagnosis is important in both children and adults. Because, if these stones cause a blockage, there may be an accompanying infection. As a result, there may be a risk of loss in kidneys that are constantly exposed to infection and obstruction. For this reason, stones that cause obstruction or persistent infection must be intervened and removed surgically.
What is the Importance of Diagnostic Examination for Kidney Stone Disease in Children?
In the presence of kidney stones in children, it is necessary to first recognize this. Since the symptoms in children are slightly different from those in adults, stones may be difficult to detect. Abdominal pain, yellowing, fading, If there are symptoms such as loss of appetite, findings such as infection or blood in the urinalysis, and stones are seen in the ultrasound, further examinations should be performed. In this case, a tomography taken without contrast would be the most appropriate imaging method to understand the location, size and number of the stone and the magnitude of the problem it creates in the urinary tract.
Sometimes, the ultrasound result may appear completely natural because the falling stone does not cause any obstruction. However, if there is sufficient doubt and if you want to clearly establish whether the cause of the problem is a stone or not, the clearest method today is a computed tomography scan, which scans the urinary tract from top to bottom with frequent sections, without the need to administer any intravenous medication.
How is the Kidney Stone Treatment Process in Children?
When a diagnosis of stone obstructing the urinary tract in children is made, this obstruction must be removed. However, if the stone is small in size, it can be expected to fall in the first place. During the fall process, the patient is monitored according to certain criteria. For example, if the patient has severe pain, persistent infection or bleeding, or the kidney begins to swell after a while, it may be necessary to act a little faster. But if these problems are minimal, it may be given a chance to pass on its own for a while.
If the stone passes on its own, the need for intervention disappears, and what can be done to prevent it from recurring is checked. In cases where the stone does not fall and an intervention decision is made, one of the first methods that comes to mind is the method in which the stone is broken inside the body by sending a sound wave from outside the body. The child is expected to pour the broken stone pieces himself. However, while such treatments can be performed without anesthesia in adults, it must be performed under anesthesia in pediatric patients. Because it is important for the child to remain still during the treatment process. Close follow-up of the child is very important after this treatment. Because the stones are only broken and left during the session, the process of shedding is followed after the session.
Apart from this, there are two basic methods applied endoscopically:
Ureteroscopic. Method:The urinary tract is entered through the hole where urine comes out and the stone is removed. It is reached up to the bone, cut into small pieces with a laser and removed in the same session. After this type of surgery, the patient can be discharged on the same day or the next day.
Percutaneous Kidney Surgery: This is a closed method applied to slightly larger stones. A very small incision of approximately 1 cm is made on the side, above the kidney. From here, a pencil-like tube is placed inside the kidney, and the stones are broken and removed by entering through this tube with endoscopes. After this surgery, patients may usually need to stay in the hospital for about two days. When he is discharged, he can continue his normal life without the need for dressing.
What is the Ureteroscopic Method in the Treatment of Kidney Stones in Children and How is it Done?
There are two methods applied closed in children. There is an important surgical method. One of these is the ureteroscopic method. This method is performed by entering the duct (ureter) that descends from the kidney to the bladder. These are completely closed transactions. There is no cutting or sewing of any part. The hole through which the urine comes out, with a camera, is about 2.5mm in diameter. It is possible to reach the bladder first, then through the canal and into the kidney by entering with devices of diameter. It is possible to see the stone in the reached area directly, break it into small pieces with a laser and take it out of the body in the same session. After such surgeries, it may often be necessary to leave a stent inside. This stent, which is a very small, soft, thin tube, remains completely inside the body, with one end in the kidney and the other in the bladder. It is usually removed within a week or ten days, depending on the condition of the urinary tract. In some cases, if the urinary tract is suitable, the surgery can be terminated without the need to leave a stent. If the urinary tract is too thin to allow this type of surgery to be performed, it may be a safer approach to end the procedure in that session by placing only a stent and to perform the main operation for the stone a few weeks later. All of these are situations that become evident during surgery. Generally, the patient who has this type of ureteroscopic surgery can be operated on in the morning and discharged in the evening or the next day, depending on the situation. If a catheter is inserted, it must be removed after a while.
What is Percutaneous Surgery in the Treatment of Kidney Stones in Children and How is it Performed?
One of the surgical methods used in the treatment of kidney stones in children is It is percutaneous surgery. The difference between percutaneous surgery and ureteroscopic treatment is that it is generally applied to larger stones (1.5-2cm and above) and is approximately 1cm from the lateral side of the kidney. It is a method applied by placing a pencil-like tube into the kidney with a special method through an incision. The stones, which are reached by entering the kidney through this pipe with camera instruments, are generally broken and taken out of the body with a different lithotripsy technique than laser, called the pneumatic method.
The place where the pipe is located is used for taking out and monitoring the urine coming from that area after the surgery. A thin catheter can be left. Usually, the next day, the condition of the kidney and whether the path is open can be checked with an x-ray taken by administering a medicated substance through this catheter. Afterwards, this catheter is withdrawn and taken out of the body. After stopping the small amount of urine discharge that may come from the surgery site, the wound is closed with a small tape and the patient is discharged. In conclusion; In percutaneous surgery, it is possible for the patient to stay in the hospital for two nights and then be discharged when he can continue his almost normal life. They return to a completely normal life within a week and ten days.
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