Pediatric Urolithiasis in Children: Diagnosis and Management Bayen Maalej 1 , Hamdi Louati 2*, Hamdi Abid 1 , Hayet Zitouni 2 , Manel Weli 1 , Mohamed Ali Zghal 1 , Lamia Gargouri 1 , Riadh Mhiri 2 and Abdelmajid Mahfoudh 1 1 Department of Pediatric emergency and reanimation, Hedi Chaker Hospital, 30219 Sfax, Tunisia 2 Department of Pediatric Surgery, Hedi Chaker Hospital, 30219 Sfax, Tunisia * Corresponding author: Hamdi Louati, Department of Pediatric Surgery, Hedi Chaker Hospital, 30219 Sfax, Tunisia, Tel: 0021652225719; E-mail: drhamdilouati85@yahoo.com Recieved date: November 15, 2017; Accepted date: November 25, 2017; Published date: November 28, 2017 Copyright: © 2017 Maalej B, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Introduction: Pediatric urolithiasis remains endemic in low-resource countries affecting children <1 to 15 years. This study aimed to investigate the diagnosis and the treatment options of pediatric urolithiasis and compare that with the literature. Materials and methods: This study retrospectively evaluated patients who had been diagnosed with urolithiasis in the in department of pediatric emergency and reanimation and the department of pediatric surgery in Hedi Chaker hospital in Sfax between 2001 and 2016. Results: Over 16 years period, we diagnosed and managed 78 children with urolithiasis. 44 were male (56%) and 34 were female (44%). The median age was 54 months (4 to 144 months). Family history of urolithiasis was found in 23 patients (29.5%). The diagnosis of urolithiasis was made after Urinary tract infection in 23 (29.5%), abdominal pain in 16 (20.5%), Hematuria in 9 (11.5%), nephritic colic in 8 (10.5%), dysuria in 11(14%) and after antenatal diagnosis of malformative uropathies in 11 (14%) patients. The treatment were surgery in 32, medical in 30, LEC and endoscopy in 8 patients. The mean of follow up was 36 months and we had 11 recurrent urolithiasis. Conclusion: Pediatric urolithiasis remains a devastating health problem. Their management requires more exploration especially in the etiology research for a best management. Keywords: Pediatric; Urolithiasis; Children Introduction Pediatric urolithiasis remains endemic in low-resource countries afecting children <1 to 15 years [1]. Urolithiasis in children should not be underestimated because of associated signifcant morbidity and higher recurrence rate as compared to adults [2]. Tis study aimed to present our diagnostic and treatment options for pediatric urolithiasis. Materials and Methods Tis study retrospectively evaluated patients who had been diagnosed with urolithiasis in the in department of pediatric emergency and reanimation and the department of pediatric surgery in Hedi Chaker hospital in Sfax between 2001 and 2016. Diferent information concerning sex, age, occupation of parents, the circumstances of discovery, the personal history, family history, location the number of urolithiases and the method of elimination of the urolithiasis. Te explorations included biology; radiology of urinary tract combining ultrasound, urography intravenous and retrograde cystography in patients with suspicion of malformative uropathies, as well as a cytobacteriological examination of urine was collected and analysed. Results Over 16 years period, we diagnosed and managed 78 children with urolithiasis. 44 were male (56%) and 34 were female (44%). Te median age was 54 months (4 to 144 months). Family history of urolithiasis was found in 23 patients (29.5%). Te diagnosis of urolithiasis was made afer Urinary tract infection in 23 (29.5%), abdominal pain in 16 (20.5%), Hematuria in 9 (11.5%), nephritic colic in 8 (10.5%), dysuria in 11(14%) and afer antenatal diagnosis of malformative uropathies in 11 (14%) patients. Urinary tract infection was present (positive cytobacteriological examination of urine) in 32 cases (42%) of cases. All patients had PUT and Ultrasound exam. CT scan was made in 26 patients, intravenous urography was made in 20 patients and retrograde cystography was made in 19 patients who had suspicion of malformative uropathies. Urolithiasis was unique in 48 cases and multiple in 30 cases. It was renal urolithiasis in 38, ureteral in 30 and vesical in 10 patients. Te treatment were surgery in 32, medical in 30, LEC and endoscopy in 8 patients and emission was spontaneous for the 8 other patients. Surgical treatment was frst intention in 22 patients who had macrocalculi, and in the other 10 patients it was afer failure of medical treatment, endoscopic or LEC. For the patients who had medical treatment it was either hyperhydration alone or hyperhydration with Cardox * . Only 44 patients of all patients had metabolic analyses, and we found Hypercalciuria in 31 patients, hyperoxaluria in 10 patients, hyperuricosuria in 5 patients, hyperphophaturia in 4 patients and cystinuria in one patient. Tese metabolic disorders were combined in more than 50% of patients with metabolic disorder. Te etiology of Maalej et al., Med Sur Urol 2017, 6:4 DOI: 10.4172/2168-9857.1000196 Research Article Open Access Med Sur Urol, an open access journal ISSN:2168-9857 Volume 6 • Issue 4 • 1000196 M e d i c a l & S u r g i c a l U r o l o g y ISSN: 2168-9857 Medical & Surgical Urology