Abstract

Objective: Pediatric cases with cystine stones compose a difficult group in respect to treatment and folow-up among the urinary system calculi. Renal insufficiency and end stage renal disease is inevitable if proper treatment is not undertaken. Cases we operated for cystine stones are presented and the treatment alternatives with follow-up results have been discussed.

Material and Method: Nine cases operated for cystinuria between the years 2009-2011 were retrospectively reviewed regarding. Treatment modalities and their results are appraised.

Results: All of our cases were male, aged between 6 months to 17 years (mean: 4.11 yrs). Bilateral stones were detected in five of our cases, and in 4 cases unilateral stones were found. Our cases were treated by PNL (n=3), RIRS (n=4), and open surgical procedures (n=2). In seven of our cases stone-free status was achieved after the procedures (77 %) while success couldn’t be achieved in two of our cases aged 1 year with bilateral stones. Bilateral stone recurrence was noted in two stone-free cases during the follow-up.

Conclusion: Being a challenging entity among other cases of urolithiasis, cystinuria is a disease requiring multidisciplinary treatment. Minimally invasive approaches must be taken as the first choice among the surgical treatment options. Necessity for repeated interventions must be informed to the parents before initiating the treatment.