Urolithiasis in the Pediatric Age Group

Abstract

Urolithiasis is usually considered a disease of adults and is rarely seen in the pediatric age group. However the incidence as well as the etiology of childhood urolithiasis is variable according to geographical areas. In countries of the Arabian peninsula (Kuwait United Arab Emirates and Saudi Arabia) it has been estimated that 20% of the men who reach the age of 60 years will have at least one episode in their lives which is a projected lifetime risk at least 50% higher than the highest corresponding figure in the West. In Europe and United States the reported incidence of urolithiasis in the pediatric age group ranges from 0.13 to 0.94 cases per 1000 hospital admissions with a predominance of upper urinary tract stones. Bladder stones on the other hand are endemic in Southeast Asia including Thailand Indonesia and India. As industrialization progresses in a geographic area there tends to be a shift in the incidence of urolithiasis from lower urinary tract to upper urinary tract stones. In the United Kingdom and certain European countries 30 to 90% of stones are infection related while in the United States and Scandinavian countries metabolic disorders are the most common cause of kidney stones. During the last two decades the introduction of extracorporeal shockwave lithotripsy (ESWL) has revolutionalized the management of urolithiasis. ESWL is now considered a safe noninvasive and effective method for treatment for urinary tract stones in adults and children. This report describes our experience in the management of childhood urolithiasis in the United Arab Emirates. (excerpt)