Epidemiology of pediatric urinary tract stones in Assiut Urology and Nephrology Hospital and its management

Introduction
Renal stone disease remains a significant health problem in pediatric urology because of its higher morbidity and risk of end-stage renal failure.
Patients and methods
We reviewed the hospital records for all patients presented to the Assiut Urology and Nephrology Hospital between December 2014 and December 2017. Data was analyzed and compared to each other to detect the incidence and prevalence of urolithiasis in each group.
Results and conclusion
Of the patients, 85.7% were adults in comparison to 14.3% who were pediatric. Urolithiasis is more prevalent among the pediatric population than adults. Urolithiasis is the second most common urological disease after congenital anomalies. Urolithiasis is much more common in boys than in girls. According to the site of stone formation, the kidney, followed by ureter, then bladder and urethra are, respectively, the most common sites. Hematuria and gastrointestinal tract symptoms are the most common clinical presentation of pediatric urolithiasis. Majority of pediatric patients with urolithiasis (62.3%) presented with obstruction in the urinary tract. Radiopaque stones formed majority of pediatric stones (64%) rather than radiolucent stones (36%). Endoscopic management is considered the main line of treatment for renal stones (36.4%) followed by extracorporeal shockwave lithotripsy (32%), medical treatment (20.6%), and then surgical management (11%). Extracorporeal shockwave lithotripsy is more common among adult population than in the pediatric. Radiolucent ureteric stones are managed mainly endoscopically. Radiopaque ureteric stones are managed according to the site.
Conclusion
Urolithiasis is a severe problem and more detailed epidemiological studies are needed to enlighten the pathogenetic factors of stone formation and its geographical variations.