Hyderabad: One of the most intriguing and concerning medical condition in children is developing kidney stones at a very young age. One such scenario is what we are describing today where a 3-year-old boy who was suffering from difficulty while passing urine, where the child used to cry every time he passed urine and frequent episodes of high-grade fever for over a month.
The child was initially treated for urinary tract infection with medications by a children specialist which gave some temporary relief but then it recurred again with the same complaints. The child was later assessed with an ultrasound which revealed two stones of size 1.6 cm each in the urinary bladder.
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The child was referred to Asian Institute of Nephrology and Urology ( AINU ), HITEC City branch for LASER treatment of urinary bladder stones. We further evaluated with a C.T scan and diagnosed with two stones one in urinary bladder and another in the left ureter ( a tube which connects the kidney and urinary bladder ) Both the stones were approximately 1.6cms which are relatively large for a 3-year-old boy. The challenge in such a scenario is to remove these stones without causing any further complications.
Dr Deepak Ragoori, Senior Consultant Urologist and Facility Director, AINU, said. “These stones are normally removed through urethra ( urinary passage ) in adults but its not the same in children as the caliber of the urethra is narrow and if we attempt the same we might cause damage to the urethra which will result in stricture urethra thereby becoming a problem for the rest of the life. Another alternative was to make a hole in the bladder just below the belly button and then remove stones, which is more invasive technique.”
Keeping in mind the child's age and potential complications of the conventional surgery, the team at AINU, HITEC City headed by Dr. Deepak Ragoori, Senior Consultant Urologist and Facility Director, Dr. MD. Taif Bendigeri, Dr. Prabhu Karunakaran ( Paediatric Urologist ) ,Dr.Leela Krishna and Dr. Nityanand Lanka ( Chief Anesthesiologist ) have decided to go ahead with endoscopic surgical option with LASER lithotripsy.
With ever improving technology and miniaturization of endoscopic instruments we were able to perform the surgery with instruments that are designed for children in specific and using an advanced Thulium Fiber LASER. The stones were transformed entirely to fine dust and sucked out with a suction machine. The surgery was completed in less than 45 min with no complications and the child was sent home the very next day. He was able to pass urine with no difficulty.
Kidney stones in children are formed primarily due to some metabolic errors or congenital deformities. These children need an expert team of super specialty doctors for an effective and safe treatment.
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