Bjazevic Jennifer, Razvi Hassan
Division of Urology, Department of Surgery, Western University, London, Canada.
Asian J Urol. 2018 Oct;5(4):223-234. doi: 10.1016/j.ajur.2018.05.006. Epub 2018 Jun 5.
Urinary stone disease is a highly prevalent condition affecting approximately 10% of the population, and has increased in incidence significantly over the past 20 years. Along with this, the rate of stone disease among women and children is also on the rise. The management of stone disease in specific populations, such as in children and during pregnancy can present unique challenges to the urologist. In both populations, a multi-disciplinary approach is strongly recommended given the complexities of the patients. Prompt and accurate diagnosis requires a high degree of suspicion and judicious use of diagnostic imaging given the higher risks of radiation exposure. In general, management proceeds from conservative to more invasive approaches and must be individualized to the patient with careful consideration of the potential adverse effects. However, innovations in endourologic equipment and techniques have allowed for the wider application of surgical stone treatment in these patients, and significant advancement in the field. This review covers the history and current advances in the diagnosis and management of stone disease in pregnant and pediatric populations. It is paramount for the urologist to understand the complexities of properly managing stones in these patients in order to maximize treatment efficacy, while minimizing complications and morbidity.
尿石症是一种非常普遍的疾病,影响着约10%的人口,并且在过去20年中发病率显著上升。与此同时,妇女和儿童中的结石病发病率也在上升。在特定人群中,如儿童和孕妇,结石病的治疗对泌尿外科医生来说可能会带来独特的挑战。鉴于这些患者情况复杂,强烈建议在这两类人群中都采用多学科方法。鉴于辐射暴露风险较高,快速准确的诊断需要高度的怀疑态度并明智地使用诊断成像技术。一般来说,治疗从保守方法转向更具侵入性的方法,并且必须根据患者情况进行个体化,同时仔细考虑潜在的不良反应。然而,腔内泌尿外科设备和技术的创新使得手术治疗结石在这些患者中得到更广泛的应用,该领域也取得了重大进展。本综述涵盖了孕妇和儿童人群结石病诊断和治疗的历史及当前进展。泌尿外科医生了解妥善管理这些患者结石的复杂性至关重要,以便在最大限度提高治疗效果的同时,将并发症和发病率降至最低。