5.13.2020 PedsUroFLO Lecture – Pediatric Nephrolithiasis

Chances of passing stone spontaneously

  • <2 mm: 3% get surgery
  • 3 mm: 14% get surgery
  • 4-6 mm: 50% get surgery
  • >6 mm: 99% get surgery

Evaluation

Blood tests: Urea, creatinine, uric acid, Na, K, Cl, Ca, P, Mag, bicarb

Random Urine tests (not 24 hr urine collection): creatinine, protein, Microalbumin, sodium, K, Ca, Uric Acid, Citrate

Stones types

Calcium oxalate/calcium phosphate 75%. No metabolic disorder found in 25%. The others can have idiopathic hypercalciuria, hyperoxaluri,a etc.

Struvite 10-15%

Uric Acid. 6%. Treat with urine alkalinzation.

Cystine 1-2%.Not amenable to swl

 

Distilled water can be used to lyse clots during ureteroscopy

Keep bladder empty during URS (girls small feeding tube alongside the ureteroscope, boys with an angiocath in the bladder if not using an access sheath.

 

Leave a Comment