Percutaneous Nephrolithotomy in Pediatric age Group: Our Experience

Pediatric urolithiasis is an uncommon disease with incidence varying widely throughout the world. We present our experience in pediatric PCNL in 20 pediatric patients with urolithiasis. Case records of all patients under 14 years of age who presented with urolithiasis from 2016 March to February 2017 were retrospectively reviewed and analyzed with respect to demographic details, clinical presentation, stone characteristics, PCNL puncture site, number, stone clearance, ancillary procedures used, complications, and follow-up status of the children. Associated biochemical abnormalities were also reviewed.   There were 25 renal units in 20 patients (5 had bilateral stones). The mean age at presentation was 8.4 years. There were 15 males and 5 females. The most common presenting symptom was flank pain (n=19/20).There were solitary stones in 17 renal units: 2 stones in 6 renal units and multiple stones in 2 renal units. The average stone size was 1.5cm. Four patients had staghorn calculi. Five patients required two punctures of whom 3 had bilateral disease and 2 had staghorn calculi. The sheath used ranged from 18 Fr to 22 Fr. The nephrostomy tube and DJ stent were kept in all patients.The duration of the procedure at a single site ranged from 45 minutes to 75 minutes. Complete clearance was achieved in 19 patients while one patient required bilateral URS. Three patients had mild fever post-operatively. None of the patients required blood transfusion. Hypocalcaemia was detected in 7 patients. PCNL is safe and effective for treating urolithiasis in children. Keywords: PCNL; Urolithiasis; Pediatric.