What Are Pediatric Urinary Stones?

Urinary stones, also known as calculi, are hard deposits made of minerals and salts that form in the kidneys or urinary tract. In children, they can be composed of calcium, uric acid, cystine, or struvite. These stones can vary in size, from tiny grains to larger structures that block the flow of urine.

Causes and Risk Factors

There are several reasons why children might develop urinary stones, including:

• Dehydration: Insufficient fluid intake is a leading cause, especially in hot climates.

• Dietary habits: Diets high in salt and protein and low in fluids can contribute to stone formation.

• Genetics: A family history of kidney stones increases the risk.

• Urinary tract infections: Recurrent infections can alter urine composition, promoting stone formation.

• Metabolic disorders: Conditions like hypercalciuria (excess calcium in urine) and cystinuria (excess cystine) are common culprits.

Symptoms to Watch For

Pediatric urinary stone disease may present with various symptoms, some of which can be easily mistaken for other conditions. Common signs include:

• Severe pain in the abdomen, side, or back

• Blood in the urine (hematuria)

• Nausea or vomiting

• Frequent or painful urination

• Fever (if infection is present)

• Crying or irritability in very young children

If any of these symptoms are noticed, it’s important to seek medical evaluation from a trusted pediatric surgeon in Pune who can perform a detailed assessment.

Diagnosis

Timely and accurate diagnosis is key to successful treatment. A pediatric urologist or surgeon will usually recommend:

• Urine tests: To check for crystals, blood, and infection.

• Blood tests: To identify metabolic abnormalities.

• Ultrasound: A safe and effective way to detect stones in children.

• X-rays or CT scans: Used in some cases for detailed imaging, though radiation exposure is carefully minimized.

Treatment Options

The management of urinary stone disease in children depends on the size, location, and type of the stone, as well as the overall health of the child.

1. Conservative Management

Small stones may pass on their own with increased fluid intake and pain management. Children are encouraged to drink plenty of water, and in some cases, medications may be prescribed to help pass the stones more easily.

2. Medical Management

If the child has an underlying metabolic disorder, long-term medications may be required to prevent recurrence. These could include:

• Diuretics

• Potassium citrate

• Antibiotics (for infection-related stones)

3. Surgical Intervention

When stones are large, recurrent, or causing blockage or infection, surgical removal becomes necessary. Pediatric surgeons are trained to use minimally invasive techniques to ensure quicker recovery and minimal discomfort.

Some common procedures include:

• Ureteroscopy: A thin scope is inserted through the urethra and bladder to remove or break up the stone.

• Percutaneous Nephrolithotomy (PCNL): Used for larger kidney stones, involving a small incision in the back.

• Shock Wave Lithotripsy (SWL): High-energy shock waves are used to break stones into smaller fragments that can be passed naturally.

A skilled pediatric surgeon in Pune can guide parents through the safest and most effective treatment option tailored to their child’s needs.

Preventing Recurrence

One of the key aspects of managing pediatric stone disease is preventing it from coming back. Parents should work closely with the treating surgeon and dietitian to implement preventive strategies:

• Hydration: Ensure the child drinks enough water throughout the day.

• Dietary changes: Reduce salt and protein intake while increasing fruits and vegetables.

• Regular follow-ups: Routine urine and imaging tests help in early detection of recurrence.

• Monitor urine output: Keeping track of the child’s urination patterns can provide early warning signs.

Emotional and Psychological Support

Children dealing with urinary stones often experience anxiety due to pain, frequent hospital visits, or fear of surgery. Support from family, reassurance from healthcare professionals, and age-appropriate communication help ease their stress. An experienced pediatric surgeon in Pune not only treats the condition but also ensures that the child feels safe and comfortable throughout the process.

Pediatric urinary stone disease is a manageable condition when diagnosed early and treated appropriately. Whether through lifestyle modifications, medications, or surgical procedures, the goal is to relieve symptoms, prevent recurrence, and ensure normal kidney function. With advanced skills and compassionate care, Dr. Vishesh Dikshit, a leading pediatric surgeon in Pune, offers comprehensive treatment solutions tailored to each child’s unique needs. If your child is showing signs of urinary stone disease, timely intervention can make all the difference in their health and future well-being.

मुलांमध्ये मूत्रमार्गात संक्रमण चे कारणे (Causes of urinary tract infections in children)

• बऱ्याचदा लहान मुले लघवी करणे टाळतात.  लघवी थांबल्यामुळे मूत्राशय आकुंचन पावते व बॅक्टेरियाचा प्रसार होतो.
• मूत्रमार्गाचा संसर्ग विषाणूंनी मूत्रप्रणालीमध्ये शिरकाव केल्याने होतो.
• मूत्रमार्ग गुद्द्वाराच्या अगदी जवळ असणे.
• फीटींग किंवा टाईट कपड्यांचा वापर करणे.
• स्वेच्छेने लघवी थांबवणे किंवा अपुरे हायड्रेशन.
• बद्धकोष्ठता (Constipation) हा आणखी एक घटक आहे, ज्यामुळे बॅक्टेरियाचा प्रसार होतो.

लक्षणे:

• सिस्टिटिस (cystitis) म्हणजे लघवी करताना तीव्र वेदना आणि जळजळ होणे. कधी कधी मुलांना इतक्या वेदना होतात की ते लघवी   करणे टाळायला लागतात.
• कधी कधी लघवी करताना  मुले जोर लावतात किंवा रडतात.
• वारंवार आणि त्वरित लघवी करण्याची इच्छा किंवा  थेंब थेंब लघवी होणे.
• लघवीचा रंग (ढगाळ)बदलणे किंवा विचित्र वास येणे.
• कधी कधी लघवीतून रक्त येणे.
• १०१ डिग्री सेल्सियसपेक्षा कमी ताप.
• ओटी पोटात दुखणे.
• पाठीत तीव्र वेदना होणे आणि थंडी वाजणे.
• मळमळ  उलट्या होऊन अन्नावरची वासना उडणे
• अनेकदा मुलांना खेळावेसे वाटत नाही आणि त्याऐवजी  ते झोपून जातात म्हणजेच त्यांना एक प्रकारचा थकवा किंवा अशक्तपणा जाणवत असतो.

उपाय:

• भरपूर पाणी पिणे . मुलांना भरपूर पाणी पिण्यास प्रोत्साहित करा. हे कधीकधी प्रारंभिक सिस्टिटिस थांबविण्यासाठी पुरेसे ठरू शकते.
• कोमट  पाण्याने अंघोळ करणे.
• प्रायव्हेट पार्ट स्वच्छ ठेवणे, मुलींसाठी पुढून मागे पुसणे कारण मागून पुढे पुसल्यास संसर्ग अजून वाढतो.
• कापडी डायपरचा वापर करणे.
• बद्धकोष्ठता (Constipation) कमी करण्यासाठी फायबर युक्त वैविध्यपूर्ण आहार.
• लघवी करण्यापासून परावृत्त करू नये.
• जेव्हा मुले आईच्या दुधाशिवाय अर्ध-घन पदार्थ, घन पदार्थ आणि द्रवपदार्थ खाण्यास सुरूवात करतात तेव्हा त्यांना आम्लयुक्त पदार्थ आणि पेये देणे टाळावे.
• बाळाला सौम्य रस, आईचे दूध, भाज्या आणि आम्लता नसलेली फळे द्यावीत .
• या रोगाची पुनरावृत्ती टाळण्यासाठी, मुलांना  त्यांच्या दिनचर्येत बदल घडवून आणण्याची आवश्यकता असते

मुलांमध्ये मूत्रमार्गात संक्रमण आजार काही संसर्गजन्य नाही त्यामुळे योग्य तो उपचार करून मुले शाळेत जाऊ शकतात. दोन वर्षांपेक्षा कमी वयाच्या मुलांमध्ये यूटीआयचे( Urinary tract infection) गंभीर नुकसान होण्याची अधिक शक्यता असते  कारण त्यांना कोणत्या प्रकारचा त्रास होत आहे हे ते स्वतः सांगू शकत नसतात. आणि म्हणूनच पालकांनी वर नमूद केलेल्या लक्षणंपैकी कोणतेही लक्षण आढळल्यास यूटीआयचे निदान करून लवकरात लवकर उपचार केले पाहिजेत.

डॉ.विशेष दीक्षित

डॉ.विशेष दीक्षित हे पुण्यातील सर्वोत्कृष्ट बालरोग शल्यचिकित्सक आहेत. त्यांना वैद्यकीय क्षेत्रातील 17 वर्षांपेक्षा जास्त अनुभव आहे. डॉ.विशेष दीक्षित यांनी 2004 मध्ये शासकीय मेडिकल कॉलेज कालिकत, केरळ येथून एमबीबीएस पदवी घेतली. 2012 मध्ये त्यांनी सायन, मुंबई येथील लोकमान्य टिळक म्युनिसिपल मेडिकल कॉलेजमधून जनरल सर्जरीमध्ये एमएस आणि 2015 मध्ये सायन, मुंबई येथील लोकमान्य टिळक म्युनिसिपल मेडिकल कॉलेजमधून बालरोग शस्त्रक्रियामध्ये MCh .  पूर्ण केले.

डॉ.विशेष दीक्षित  त्यांनी शिक्षण पूर्ण केल्यानंतर पाच वर्षे सायन हॉस्पिटलमधील बालरोग शस्त्रक्रिया विभागात प्राध्यापक आणि प्रशिक्षक म्हणून काम केले. विशेषतः, त्यांना  Pediatric Minimal Access  शस्त्रक्रिया (लॅपरोस्कोपी, थोरॅकोस्कोपी आणि जेनिटोरिनरी-स्कोपीद्वारे), लहान मुलांचे कोलोरेक्टल रोग (हिर्शप्रंग रोग आणि एनोरेक्टल विकृतीसह), आणि बालरोग मूत्रविज्ञान रोगामध्ये अधिक अनुभव आणि कौशल्य  आहे.

Reasons for Urinary Tract Infection in Children

Parents always need to understand the reasons why children get infected with UTIs. Let’s check the reasons below.

• Experts say that bacteria from the child’s skin can reach the urinary tract and lead to a Urinary Tract Infection.
• The urinary tract inside a child’s body can often get infected with bacteria coming from the bloodstream.
• Sometimes, children hold their pee for a long time, and this bad habit can cause urinary tract infection.

Symptoms of UTI

Normally, parents hardly understand the symptoms of urinary tract infection in their kids. But, they need to check some symptoms like fever, bad-smelling urine, irritability, crying, fussiness, vomiting, poor feeding, and more to identify whether their kids are suffering from UTI.

Apart from those mentioned above, children can also suffer from the difficulties like urgency to urinate, frequent urination, feeling pain during urination, trouble urinating, blood during urination, etc. If you notice the symptoms mentioned above, you need to consult with Dr.Vishesh Dikshit Best pediatric urologist in Pune. 

Ways to prevent UTI

Proper treatment will cure your kids of urinary tract infection, and to prevent them from this problem, parents need to focus on the following facts.

• Children need to take plenty of fluids like water, fruit juice, etc
• Educate your child to empty their bladder completely while urinating.
• Experts suggest avoiding bubble baths and using perfumed soap while bathing
• Children should not eat such food or beverages that will cause irritation in the bladder.
• Parents need to check that their kids do not get constipated.

About Dr. Vishesh Dikshit

It has been noticed that many children below the age of two years suffer from bladder infection. The difficulty lies in the fact that these kids are too little to express how they feel during the infection. Normally, when a young child suffers from a bladder infection, they can have fever, vomiting, diarrhea, fussiness, loss of appetite, etc.

Children who are more than two years of age can have problems like pain or burning during urination, cloudy, bloody, dark urine with foul smell, frequent urge to urinate, pain in the lower abdomen and fever.

Causes of Bladder Infection in Children

 The prime cause of Urinary Tract Infection is bacteria, and E-coli is the primary bacteria responsible for bladder infection. This bacterium is present in abundance in the stools and it travels from there to the urinary system to cause UTI.  A child’s body can often not fight the infection, which creates critical health conditions that may put your children at risk.

Preventive Measures of Bladder Infection

Doctors often suggest parents take necessary preventive measures at home so that they can prevent bladder infection affecting their children.

• Parents need to check that kids always drink enough water to stay hydrated. Frequent urination helps to flush out the bacteria.
• Proper hygiene of the private parts is another way to keep your kids free from a bladder infection. Avoid using diapers. Use clean cotton underwear which must be changed as frequently as they get soiled.
• Parents need to check whether their kids have constipation or not. It is common for kids to have constipation and a loaded rectum compresses the urethra making it difficult for children to pass urine which leads to stagnation and infection. If your kids suffer from constipation, you need to take corrective measures to relive the condition. Your doctor will help you with that.

Often if your kids are infants with high grade fever and no other symptoms, you need to get them examined so as to rule out and treat Urinary Tract Infection (UTI). Many a times children have structural problems in the urinary tract which can cause repeated UTI. A pediatric surgeon can help you with this.

Causes of Urinary Tract Infection

Urinary tract infection develops when bacteria reach the bladder. In this situation, the bacteria start multiplying and infecting the area. Normally there are two types of urinary tract infections- one is a kidney infection, and the second one is a bladder infection. A kidney infection is more harmful than a bladder infection. When children suffer from a urinary infection, two types of abnormalities are mainly found to be associated : Vesicoureteral reflux and Urinary Obstruction.

Symptoms of Urinary Tract Infection

Symptoms of urinary tract infection depend on the level of infection in the child. The normal symptoms are fever, low appetite, diarrhea, vomiting, irritation, and overall weakness. In case of bladder infection, the kids may also have foul-smelling urine, blood in the urine, frequent urination, cloudy urine, pain during urination, etc.

Urinary Tract Infection Treatment Options 

No doubt, urinary tract infection can cause serious effects on the kidney’s health and hence it is necessary to ask your doctors about the best remedies. Doctors will suggest certain antibiotics that can immediately stop the infection from spreading to the kidneys.

Sometimes kids need to get hospitalized if they are younger than 6 months, suffering from high fever, blood infection due to bacteria and excessive vomiting or diarrhea. Doctors will suggest certain laboratory tests like urine culture to analyse the type of bacteria so that the right treatment can be provided.

We generally do not associate boys with urinary tract infections, however once it occurs, it can be harmful to anyone. This happens when bacteria (usually from stool in the diaper) manage to get inside the urethra. When this happens, boys can have a feeling of burning when they urinate, pain in the lower tummy, fever and/or vomiting. The urine may have a very foul smell. Some boys may also have an increased frequency of micturition and bedwetting. Parents need to be very sensitive about this condition and seek immediate medical help.

2. Kidney Stones

Kidney stones are like small pebbles, some smooth others irregular. They occur due to deposition of calcium and other minerals. They can form as a sequalae to infection or sometimes due to some underlying metabolic disease. Children with kidney or urinary tract stones most commonly present with pain and blood-tinged urine. An ultrasound is helpful in locating the stones. There are many strategies available to tackle such stones depending on its size and location.

3. Hypospadias

This is a very common abnormality in which the urethral opening is not present at the tip of the penis but may be located anywhere on the undersurface of the shaft or even in the scrotum. The child may also have a bend in the penis, called a chordee, along with incomplete foreskin. Even though this condition is present since birth, it is best corrected with surgery at around 8-10 months of age.

4. Hydronephrosis

This literally means “A kidney full of water.” Here the kidney swells up with urine and is due to some outflow obstruction. Very often this condition is detected by ultrasound before birth. Many cases of antenatally detected hydronephrosis resolve as the baby grows but some need constant monitoring and surgical intervention to remove the block.

5. Posterior Urethral Valve

Even though this is not a very common disease, it still is the most severe type of urinary block affecting boys. There is a membrane in the urethra just below the bladder which causes lower urinary tract obstruction and many problems like hypertrophic and poorly functioning bladder, vesico-ureteric reflux and poorly functioning kidneys along with underdeveloped lungs. Management of such cases is tough and needs a multidisciplinary approach using medical and surgical intervention.

Dr. Vishesh Dikshit is the Best Pediatric Surgeon in Pune. If you have any problem related to your child’s Pediatric Urology condition Book your appointment today with Dr. Vishesh Dikshit at Umarji Mother and Child Care Hospital, Pune.

 Common Pediatric Urology Conditions:

Many parents do not have knowledge about the different urological problems that can occur in kids. However, they can scroll down and check the details here.

 Hypospadias:

This problem is mainly caused due to the malposition of the urethral opening, and about one in 250 male babies suffer from this problem. Normally pediatric surgeons conduct corrective surgery at the nine months age of the baby.

 Antenatal hydronephrosis:

This problem is seen in fetuses as a dilatation in the renal pelvis. Normally doctors can identify this problem ante-natally using sonography. This is quite a common finding, and almost 50 percent of babies are detected to have this problem before birth. Fortunately, in the majority of babies, this condition resolves as they grow and only some need treatment.

Nocturnal enuresis:

This problem is commonly known as bedwetting. Normally children attaint nighttime control over their bladders by the age of five but for some, it may get delayed to seven years. If your child is still wetting the bed after the age of seven, please consult your doctor.

Undescended testes:

Many male babies are born with their testes not present in the scrotal sac but in most of them it comes down by the age of seven months. Beyond that age, if the testes are still undescended, they need to be brought down surgically to avoid complications like infertility, torsion, trauma, and tumors.

 Ureteropelvic junction (UPJ) obstruction:

This condition occurs in around one in 500 babies and is usually detected before birth. It occurs due to blockage of the outflow of urine from the kidney into the ureter. Many of such babies get better as they grow but few require surgical correction in the form of pyeloplasty.

If your child is suffering from any of the above problems, Consult today with the best pediatric surgeon in Pune – Dr. Vishesh Dikshit. Book an Appointment Now!