Treatment of Urinary Tract Stones in Children Without Surgery

Treatment of Urinary Tract Stones in Children Without Surgery

Although urinary tract stones in children are less common than in adults, they can lead to major complications if left untreated. Traditionally, surgical intervention was the only treatment for this condition. However, now, with the leadership of Dr. Enmar Mohamed Habib, Professor of Urology and Pediatric Urology at Cairo University and Fellow of McGill University, Canada, it is possible to treat urinary tract stones in children without surgery. Thanks to flexible endoscopic and laser techniques, children can receive the best treatments with minimal pain and complete safety.

What are urinary tract stones in children?

• Urinary tract stones (urolithiasis) are the formation of stones in the bladder, ureters, renal pelvis, or kidney cysts. These stones can vary in shape and size among children, ranging from the size of a grain of sand to that of a golf ball (in severe cases). When tthese stones become larger than the urethra, they can remain in place and cause severe pain.
• Stones usually pass from the kidneys into the ureter (the small tube that connects the kidneys and bladder). Some stones are small enough to pass through the urethra unnoticed. Other stones are larger than the urethra and become stuck when trying to pass, causing urine to become trapped in the kidneys, ureter, bladder, or urethra (the tube that takes urine out of the bladder and out of the body), depending on the stone's location. 

What are the different types of urinary tract stones in children?

Urine typically contains many dissolved substances. Occasionally, some substances may concentrate in the urine and form solid crystals. These solid crystals build up, leading to the formation of urinary tract stones. Some types of stones include:
1. Calcium stones: These are the most common kidney stones in children. Typically, the body gets rid of excess oxalate through the kidneys, but if there is too much oxalate, it combines with calcium, resulting in the formation of calcium stones.
2. Cystine stones: Cystin stones are a side effect of a genetic disorder called cystinuria. These stones form when the amino acid cysteine accumulates in the urine. Cystinuria affects how the kidneys absorb cystine. Without the kidneys' ability to properly reabsorb this amino acid from the urine, it remains in the urine at high levels, leading to the formation of stones.
3. Struvite stones: This type usually forms after an infection in the upper urinary tract (kidneys and ureters). Struvite stones can develop quickly and become large. They often affect children whose urinary systems haven't developed normally.
4. Uric acid stones: Uric acid stones form when uric acid accumulates in a child's urine, whether due to diet or certain genetic conditions. The body produces uric acid because of the breakdown of substances called purines, compounds found in many foods and beverages.

What are the symptoms of urinary tract stones in children?

Stones may form in a child's kidneys without causing symptoms for a long time. However, the stone may move through the ureter, causing symptoms such as:
• Sudden, severe pain in the back, side, lower back, or groin area.
• Blood in the urine (hematuria).
• Frequent urge to urinate or inability to urinate.
• Burning or pain during urination.
• Nausea and vomiting.
• Fever and urinary tract infection.
Identifying the exact symptoms that children are experiencing can be challenging. Therefore, it is important to consult Dr. Enmar Mohamed Habib, who is highly skilled in dealing with urinary issues in children and performing an appropriate diagnosis.

Why do urinary tract stones form in children?

There are many causes and risk factors for urinary tract stones in children. Some of these include:
1. Not drinking enough water: Insufficient water and fluid intake is one of the most common causes of stone formation. If a child doesn't drink enough fluids during the day, the urine becomes dark and concentrated, increasing the chances of stone formation due to the lack of fluid available to dissolve the small crystals.
2. Diet: A diet high in salt and protein increases the chances of stone formation. Excessive caffeine intake found in tea, coffee, and chocolate increases diuresis, which increases the likelihood of stones.
3. Certain genetic conditions: Certain genetic conditions, such as cystinuria, cystic fibrosis, and renal cysts, increase the chances of urinary tract stones in children.

Treatment of urinary tract stones in children:

Treatment methods vary depending on the size and type of stone a child has, as follows:

1. Drug therapy:

If there is a chance that the stone will pass on its own, medications are prescribed to help the ureter relax, allowing the stone to pass and preventing nausea and vomiting. The child's lifestyle and dietary habits should also be changed, such as increasing water intake and reducing caffeine and salt intake.

2. More invasive treatments:

Stone removal techniques are recommended in the following cases:
• The stones do not pass within 15 days, or the child has persistent pain.
• The child has a fever.
• The stone is so large that it cannot pass on its own.
• Stones that block the urine flow.
• Stones that cause a persistent urinary tract infection.
• Stones that damage the kidneys or cause persistent bleeding.
In those cases, surgery was the only treatment option due to the small size of the children's urethra. However, the surgical treatment involved large incisions and a long recovery period, making the treatment laborious and tiring for children and parents alike. Thanks to the pioneering work of Dr. Enmar Mohamed Habib, urinary stones in children can now be treated non-surgically with the innovative Holmium Laser.

Non-surgical treatment of urinary tract stones in children using flexible endoscopy and laser:

• These techniques are among the latest treatment methods used to treat urinary tract stones in children without surgery. The procedure involves the use of a flexible endoscope (a flexible tube with a camera) to locate stones, especially in areas difficult to see through traditional endoscopes, such as the upper ureter and renal pelvis.
• The flexible endoscope is inserted through the urethra and into the ureter, and once the stone is located, the stone is split into several pieces using a laser (holmium laser). The fragments are evacuated in the same procedure to ensure that the stones do not form again.
Dr. Enmar Mohamed Habib is always committed to using the latest methods and techniques in treating urinary tract stones in children so that they achieve the best results with minimal pain during treatment.

What are the benefits of using a flexible endoscope and laser to break up urinary tract stones in children?

• This technique is safer than open surgery, which requires a large incision.
• This procedure can remove stones larger than 1 cm in size, with high efficiency compared to other procedures.
• The use of a flexible endoscope makes it possible to reach areas that were previously inaccessible with traditional endoscopes.
• The child can be discharged from the hospital on the same day of the procedure, minimizing recovery time and speeding up the return to daily activities.

In conclusion, Dr. Enmar Mohamed Habib, Professor of Urology and Pediatric Urology at Cairo University and Fellow of McGill University, Canada, with his skill in treating urinary tract stones in children without surgery, offers a better option than traditional surgical methods that are painful for children. This ensures the best care for children suffering from urinary stones. Don't hesitate to get your consultation now.