|
What
are the symptoms of urine stones?
There can be no symptoms when a stone is present.
When a stone is blocking urine passage in the kidney or
urinary tubes, severe loin pain results.
When there is a stone in the urinary bladder, there will
be pain at lower part of belly or the penis.
Pain when passing urine, blood in urine or even passing
small stones or gravel can be present.
Small babies cant tell these. When children cry while
passing urine or when there is urine infection, it is
essential to rule out a stone.
How is a stone detected?
When children experience the above symptoms, urine is
tested in the lab. Presence of excess red cells or white
cells; and presence of crystals in the urine suggests
urinary stone disease. Ultrasound scan helps to find out
whether there is a stone, the position, size and number
of stones. In addition special tests like IVP, X-Ray, or
CT scan may be required.
What are the treatments available to remove the
stones?
There is a general misconception that childhood stones
always require open surgery. Like adults children also
can be treated without open surgery. In modern medicine
facilities are available to break stones and 80% are
removed without open surgery. For this it is essential
to consult a pediatric urologist trained in this field.
Endoscopic treatment
When stone is present in the bladder, it can be removed
with the help of an endoscope. Endoscope is a small tube
with a camera that is passed up via the urinary passage.
The stones are grasped with small grabbers. Bigger
stones can be broken with the help of a technique called
lithotripsy. As children won’t stay still, they need a
general anesthesia. To prevent blockage by broken stone
pieces, a small tube called stent is left in for 2-3
weeks.
|
|
Breaking
Stones
A technique called ESWL uses sound waves to break stone.
With the help of an x-ray or a scan the stone is
focused. ESWL machine breaks the stone in less than an
hour. Sometimes a second sitting may be required for
complete stone clearance. With this treatment, children
can return home with a couple of days. Small children
need general anesthesia, as they have to lay still for
this.
Can stones come back? How can we prevent this?
Children have a 20-50% higher chance for the stone
recurrence. Problems like passing excess calcium in
urine can be there. It is essential to identify this to
prevent further stone formation. Regular toileting and
drinking plenty of water are essential to prevent stones
and urine infection.
What are the dietary restrictions in children with
stones?
In general drinking plenty of water (10-20 cups) helps
to reduce stone formation.
Salt should be restricted in diet.
Non vegetarian foods and milk products need to be
reduced.
Cabbage, spinach, cashew, walnut etc need to be avoided.
Coffee, tea, cola, apple and grape juices need to be
restricted.
Orange and lime juices are good.
Vitamin D and calcium tonics should be avoided.
Key Points
Like adults children can also develop urinary stones.
Children can have underlying medical problems that make
them prone to develop stones.
It is essential to identify and treat these to prevent
stone recurrence.
With the advent of newer facilities, 80% of stones in
children can be removed without open surgery.
It is essential to consult a paediatric urologist
trained in this area to obtain the appropriate
treatment.
|
