Urolithiasis

Abstract

Urolithiasis has been known for a very long time. Although pediatric urolithiasis is common, there is great variation in the incidence, prevalence, stone composition, and etiological factors, leading to a complex pathogenesis. This review examines pediatric urolithiasis in a developing country, highlighting the epidemiology and clinical presentations (including stones in infancy), including patients presenting without having been previously treated and with renal failure. Stone composition shows a predominance of ammonium hydrogen urate (AHU). Dietary and metabolic evaluations identified the risk factors in many of these patients. The majority of these patients can be managed by minimally invasive surgery, including extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and ureterorenoscopy (URS). However, open surgical procedures still have a limited, although important, role for patients with anatomical abnormalities and large stone burdens with sepsis.