Endoscopic diagnosis and treatment of 500 children with urinary calculi in Xinjiang

Abstract

Objective To explore the risk factors, clinical features and treatments of urolithiasis in children. Methods Summary analyses were performed for 500 children of urolithiasis from January 2014 to December 2017. There were 336 boys and 164 girls with a mean age of 7.0±0.5 years. They came from South (n=430) and North (n=70) Tianshan Mountains respectively. The ethnicities were Uygur (n=420) and others (n=80). Stone was located in kidney (n=341), ureter (n=67), kidney & ureter (n=55) and bladder & urethra (n=37). Upper urolithiasis complicated with infection (n=336, urine routine WBC+ -+ + + + ) and lower urolithiasis complicated with infection(n=37, urine routine WBC+ -+ + + + ) were detected. The symptoms included abdominal pain (n=100), hematuria (n=50), abdominal pain with hematuria (n=150) and anuria (n=36). The symptoms were urethral irritation (n=104) and non-typical (n=59, including 15 cases of concurrent hydronephrosis). None of them had a family history of urinary urolithiasis. Results A total of 495 cases were successfully treated endoscopically. Four cases of ureteral urolithiasis incarceration and perforation were converted into open surgery. And one case of bladder urolithiasis was too big so that bladder incision was selected. Statistics indicated that urinary urolithiasis in Xinjiang had some relationship with its region. Uighur children with younger age were more vunerable. The major clinical manifestation of upper urolithiasis was abdominal pain with hematuria while that of lower urinary calculi urethral irritation. Most cases of urinary urolithiasis were complicated with urinary tract infection. Upper urolithiasis complicated with urinary tract infections was more common than lower counterpart. Conclusions A great majority of Xinjiang children of urolithiasis live in southern Xinjiang and they tend to have abdominal pain, hematuria and urethral irritation. Endoscopic treatment of urinary urolithiasis may replace open surgery in children. Key words: Child; Urinary calculi; Surgical procedures, minimally invasive; Endoscopes