Stone Center

  • Treatments for Stone Conditions

    The Stone Center uses two main approaches to treating your child’s condition – medical and surgical management.  Your doctors will work together and with you to decide what is best for your child. 

  • Medical Management

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    Medication

    The treatment for urinary tract stones in children depends on the size of the stone, the location of the stone, composition of the stone, amount of pain the stone is causing, and whether the stone is blocking any portion of the urinary tract.

    Your child may require pain medication, depending on the severity of the pain.

    Your child may be encouraged to increase fluid intake to aid in passing the stone through the urinary tract, or your child may require IV fluids if he or she is unable to drink.

    Other common medications prescribed may include diuretics (water pills) and citrate supplements.

    Education

    Patient and family education is individualized based on family history and risk for stone formation. Providing information about diet, medication and exercise to prevent stones is key to minimizing recurrent stone formation and maximizing kidney function.

    Care is provided on an individualized basis.  Children with stones may have other complex medical conditions.  Our Stone Center team has the ability to consult with other pediatric medical specialties such as cardiology, pulmonology and neurology to meet the specialized needs of your child.


  • Surgical Management

    Surgical treatment may be considered if your child has a larger stone in the urinary tract that is blocking urine flow and/or causing a large amount of pain.  Our team of pediatric urology surgeons and pediatric anesthesiologists work collaboratively to provide the best surgical outcome.  Procedures that may be considered include:

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    Lithotripsy

    ESWL (extracorporeal shock wave lithotripsy) is a procedure that uses outside energy to break up the stone. No incision (cut in the skin) is needed. Before the procedure, a moving X-ray locates the stone, and then the energy waves crush the stone into very small pieces. The small stone pieces pass when the child urinates.

    Patients usually go home the same day of the procedure and return to normal activities in one to three days. Your child should not be involved in vigorous physical activity if a ureteral stent is placed to help the stone fragments pass.

    Ureteroscopy

    This treatment involves use of a small telescope (ureteroscope) to access stones in the ureter (tube that goes from the bladder to the kidney) or kidney. No cut in the skin is needed since the scope enters at the urethra (opening which allows urine to exit body), proceeds to the bladder and the ureter.

    When the stone is seen it can be removed with a basket-like tool. If the stone is large, a laser can be used to break it into very small pieces. 

    Ureteral Stent Placement

    A ureteral stent may be placed after the ESWL or ureteroscopy procedures. It may also be placed without any other procedure, to assist the stone to pass down the ureter.

    The stent is a thin, flexible tube that extends from the kidney to the bladder. It prevents blockage of urine due to swelling or buildup of stone fragments. The stent cannot be seen from outside the body.

    Contact sports and physically strenuous activities must be avoided.

    The child may feel some discomfort, and feel the urge to urinate often. The urine may appear pink or red. These symptoms will disappear when the stent is removed several weeks later.

    Antibiotics and a medication to stop bladder spasms (from irritation of the bladder wall by the stent) will be prescribed. 

    Percutaneous Nephrolithotomy

    This procedure is used when a very large stone is located in the kidney or when other treatments fail. A small cut is made in the lower back and a small telescope is inserted into the kidney. Once seen, the stone can be broken into smaller pieces and removed.

    The doctor may place a small flexible tube called a nephrostomy tube directly into the kidney through a small opening in the back. The tube will extend from the kidney to the outside of the child's lower back and will temporarily drain urine from that kidney into a bag. The nephrostomy tube is usually removed after two to three days.