Symptoms and diagnosis of kidney stones in children

Kidney stones are said to be able to hurt like childbirth, although at the moment, theirs is that births do not hurt. We are used to seeing them in adults, but in the pediatric age, they can also be seen. We talk about kidney stones. Next, we will reveal some of its characteristics.

Why kidney stones appear in children

Regarding its origin, there are calculations that appear spontaneously, others are secondary to abnormalities in the shape of the urinary tract, infections or metabolic disorders (among them, idiopathic hypercalciuria stands out, an entity that presents with an increase in the excretion of calcium in the urine). Obesity, sedentary lifestyle and heat (especially if the child does not adequately replenish the losses of fluids by sweating with water) favor their appearance.

Up to 50% of cases, there is a family component. That is, some component of the family has had some similar problem.

Symptoms, diagnosis, and treatment of kidney stones in childhood

From a clinical point of view, the most important manifestation is the pain. It is a very intense pain, located on both sides, and radiating to the abdomen. It is described as ‘exasperating’ (the child changes incessantly from a position), and associates with a vegetative procession of vomiting and cold sweat. The movement of the stone produces small erosions on the renal path, so the child bleeds. This bleeding is often evident in the urine.

The diagnosis can be established by the kidney hospital in Palam, West Delhi, and to document it we can resort to a urinalysis (in which we will see an increased number of red blood cells) and an imaging test (ultrasound, abdominal x-ray or tomography).

For kidney stone treatment, it is essential to hydrate the child (orally or intravenously, if he is very nauseous) and provide analgesia. In complex cases, before voluminous calculations, it is necessary to resort to surgery by the urologist in West Delhi. The calculations secondary to specific metabolic diseases require an individualized preventive kidney stone treatment in Uttam Nagar, West Delhi.

Holmium Laser Enucleation of the prostate (HoLEP) is a modern alternative to the standard Transurethral Resection of the Prostate (TURP) procedure for bladder outflow obstruction due to BPH. It requires a short period of hospitalisation and an anaesthetic.

HoLEP can be performed on men of any age with urinary outflow obstruction caused by an enlarged prostate. It is particularly indicated in men with large prostates (over 60mls in size) and men on medications to thin the blood such as warfarin, aspirin or clopidogrel.

Advantages of HoLEP

• There is no upper size limit of prostate that can be dis-obstructed – traditionally men with prostates over 100ml in size needed major open surgery
• There is often less bleeding than after a TURP
• Discharge is often quicker than after TURP at 1-2 days
• The chance of recurrence requiring further surgery is very low
• Unlike greenlight laser operations, large quantities of prostate tissue are sent for pathological analysis
• The PSA generally drops to very low levels after HoLEP operations.

AIM OF HoLEP
The aim of HoLEP is to relieve pressure on the tube through which the urine drains (urethra) by anatomically enucleating the majority of excess benign prostate tissue. This is done under a general anesthetic with the help of a telescopic camera inserted through the penis. The three lobes of the prostate that are cored out intact are pushed into the bladder before being sucked up (morcellated) by a special instrument inserted through the telescopic camera. The pieces are sent for laboratory analysis just in case they might be found to be cancerous. A catheter is placed into the bladder to drain the urine while the raw surface heals, then left in place for around 24 hours before being removed on the day of discharge from the hospital. Sterile saline fluid is also irrigated into the bladder through the catheter to dilute any blood in the urine and prevent clots from forming.

Laparoscopic Pyeloplasty provides patients with a safe and effective way to perform reconstructive surgery of a narrowing or scarring where the ureter (the tube that drains urine from the kidney to the bladder) attaches to the kidney through a minimally invasive procedure. This operation is used to correct a blockage or narrowing of the ureter where it leaves the kidney. This abnormality is called a ureteropelvic junction (UPJ) obstruction which results in poor and sluggish drainage of urine from the kidney. UPJ obstruction can potentially cause abdominal and flank pain, stones, infection, high blood pressure and deterioration of kidney function. When compared to the conventional open surgical technique, laparoscopic pyeloplasty has resulted in significantly less post-operative pain, a shorter hospital stays, earlier return to work and daily activities, a more favorable cosmetic result and outcomes identical to that of the open procedure.

The Surgery
Laparoscopic pyeloplasty is performed under a general anesthetic. The typical length of the operation is 3-4 hours. The surgery is performed through 3 small (1cm) incisions made in the abdomen. A telescope and small instruments are inserted into the abdomen through these keyhole incisions, which allow the urologist in West Delhi to repair the blockage/narrowing without having to place his hands into the abdomen.

Ureteropelvic Junction (UPJ) Obstruction

A small plastic tube (called a ureteral stent) is left inside the ureter at the end of the procedure to bridge the pyeloplasty repair and help drain the kidney. This stent will remain in place for 4 weeks and is usually removed in the kidney hospital in West Delhi. A small drain will also be left exiting your flank to drain away any fluid around the kidney and pyeloplasty repair.