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Contemporary minimal invasive surgical management of stones in children

Asian Journal of Urology 2023年第3期10卷 239-245页

作者： Rasim Guzel Umit Yildirim kemal sarica Department of Urology Medistate Kavacık HospitalIstanbulTurkey Department of Urology Medical SchoolKafkas UniversityKarsTurkey Department of Urology Medical SchoolBiruni UniversityIstanbulTurkey

Objective:Pediatric urolithiasis has been more common over the past 20 years,and urologists have unique challenges in managing it surgically because this particular demographic is recognized as one of the high-risk categories for stone *** this reality,care focuses on maintaining renal function,achieving total stone-free status,and most importantly avoiding stone *** this presented article,we aimed to make a comprehensive review of the current minimally invasive treatment of pediatric kidney stone ***:We evaluated the results of 74 studies following a comprehensive PubMed search till February *** article was written by making use of current urology ***:Considering the reported occurrence of metabolic issues in up to 50%of cases in addition to the anatomic anomalies(about 30%of cases),the treatment of pediatric urolithiasis necessitates a full metabolic and urological examination on an individual *** management of metabolic imbalances and obstructive diseases is *** addition to encouraging proper fluid consumption,it is advisable to improve urine volume and consider using medical therapeutics to raise urinary citrate *** location,content,and size of the stone(s),the morphology of the collecting system,the presence of urinary tract infection,as well as the presence of any obstruction,should all be taken into consideration while deciding on the best surgical ***:All modern endourological methods are now used in the safe and efficient care of pediatric urolithiasis as a consequence of the obvious advancements in instrument technology and expanding expertise derived from adult *** minimally invasive procedures,such as ureterorenoscopy and percutaneous nephrolithotomy,require more expertise and can be successfully applied with careful management for an excellent stone-free rate with minimal *** these procedures,shock wave lithotripsy is still the first ch

关键词： Urinary calculi Shock wave lithotripsy Percutaneous nephrolithotomy Ureteroscopy

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Diagnostic value ultrasound signs of stones less than or equal to 10 mm and clinicoradiological variants of ureteric colic

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Asian Journal of Urology 2023年第1期10卷 39-49页

作者： Denis V.Krakhotkin Volodymyr A.Chernylovskyi kemal sarica Arman Tsaturyan Evangelos Liatsikos Jurijus Makevicius Nikolay Yu Iglovikov Dmitry N.Pikhovkin Central District Hospital Outpatient ClinicSadovaya Lane 23KamenolomniRostov RegionRussia Private Urological Practice DniproUkraine Department of Urology Biruni University HospitalInstanbulTurkey Department of Urology University Hospital of PatrasPatrasGreece Department of Urology Medical University of ViennaViennaAustria Institute for Urology and Reproductive Health Sechenov UniversityMoscowRussia Institute of Clinical Medicine Faculty of MedicineVilnius UniversityVilniusLithuania Department and Clinic of Urology S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian FederationSt.PetersburgRussia Central District Hospital Department of SurgeryLenina Avenue 28AksayRostov RegionRussia

Objective:To determine the diagnostic value of ultrasound signs of urinary stones less than or equal to 10 mm and to determine clinico-radiological variants of ureteric ***:A total of 455 ultrasound investigations were performed in patients referring to emergency department with urolithiasis and symptoms suspected of ureteric colic between January 2021 and May *** addition to microscopic evaluation of urine sediment to detect different crystals and non-contrast spiral computed tomography to detect stones,B-mode and color Doppler sonography was performed to assess the presence of acoustic shadow(AS)and twinkle artifacts(TA)as possible signs of stone(s)in ***:While the sensitivity and specificity of AS and TA were higher than 90%in patients with stones greater than 5 mm;positive prognostic values of these parameters were found to be extremely low for stones with sizes of 1-3 mm with specificity and sensitivity values not exceeding 53%.The sensitivity and specificity of AS and TA in the upper and lower ureters were higher for stones greater than or equal to 5 than for compared to those less than 5 *** the same time,the diagnostic values of TA and AS for middle ureter stones were very *** most prevalent clinico-radiological variants of ureteric colic were types I,III,and V being observed in 39%,28% and 21% cases,***:Our results demonstrate that TA and AS parameters seem to have a very low sensitivity and specificity in the diagnosis of urinary stones less than 5 *** diagnostic value of TA and AS increase significantly in stones greater than or equal to 5 ***,clinicians need to be very careful for overestimating the diagnostic values of TA and AS for stones less than 5 mm and non-contrast spiral computed tomography must be the method of choice for patients presenting to emergency department with ureteric colic.

关键词： Ureteric colic Urolithiasis Ultrasound Twinkle artifact Non-contrast computed tomography

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