Surgical Management of Pediatric Urolithiasis: Descriptive Study from a Tertiary Care Center in Nepal

Abstract

Introduction: Urolithiasis is common in the pediatric population in low-resource countries but appropriate management is not available in all parts of the country. This study aimed to identify demographic parameters, clinical characteristics, and surgical management of pediatric urolithiasis in a tertiary care center in Nepal.

Methods: This was a retrospective and descriptive study of pediatric patients (≤18 years) who underwent surgical management of urolithiasis in the Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital from January 2021 to December 2022.

Results: Total 64 patients with Male: Female ratio 1.78:1 and mean age of 8.63±5.56 years presented mostly with pain abdomen (93.8%) followed by lower urinary tract symptoms (26.6%), hematuria (20.3%), and fever (14.1%). The mean number of calculi was 2.2±1.47 and the mean size was 13.97±8.30 mm. Most of the calculi (39.1%) were in the right system and 90.62% were in the upper tract. Only 15.62% of patients had calculi in the lower tract. Open surgeries were performed in only 10.93% and the rest were managed by minimally invasive procedures. Percutaneous nephrostomy tube insertion was done in 6 (9.37%) of patients and 1 (1.56%) underwent nephrectomy for nonfunctioning kidney.

Conclusion: Pediatric urolithiasis patients presented with pain abdomen, lower urinary tract symptoms, or hematuria. Surgical management has shifted from open surgeries in the past to minimally invasive surgeries at present.