At OHSU Doernbecher Pediatric Urology we partner with pediatric kidney specialists and pediatric radiology to provide comprehensive imaging, diagnosis, prevention and treatment of kidney stones in children.
We participate in the “Image Gently” national campaign to reduce the amount of radiation exposure any child receives from medical imaging. Our team has made great strides in reducing the amount of radiation that a child receives when being evaluated and treated for a kidney stone.
Metabolic Stone Clinic
What are kidney stones?
A kidney stone is a piece of solid material that forms in the kidney when minerals in the urine become very concentrated. Small stones often pass through the body with little discomfort, but larger stones can be very painful and even block the urinary tract. Many doctors report seeing more children with the condition in recent years, possibly because of lifestyle and dietary factors.
What causes kidney stones?
Stones can form if a child has a defect in the urinary tract that keeps urine from flowing properly. Genetic factors, diet, drinking too little water, urinary tract infections and certain metabolic disorders also can increase the likelihood that a child will have kidney stones.
What are the symptoms?
Children with kidney stones may have pain when urinating, blood in their urine or pain in the back or lower abdomen. Sometimes the pain causes nausea and vomiting. Small stones can pass through the urinary tract without causing any symptoms at all.
How are kidney stones diagnosed?
A combination of urine, blood, and imaging tests can be used to determine whether a child has a kidney stone. Urine tests can detect infections or elevated levels of substances that form stones. Blood tests can help diagnose biochemical problems that can lead to kidney stones. Imaging techniques that may be used to locate the stone include ultrasound, in which sound waves are used to image organs and their structures; computerized tomography (CT), which combines X-rays with computer technology to create three dimensional images of the urinary tract; and conventional X-rays.
How are kidney stones treated?
Our goal is to resolve your child’s kidney stone(s) with minimal discomfort.
Treatment depends on the size of the stones and a child’s symptoms. Small stones usually pass through the urinary tract on their own, and children may only need to drink extra fluids and take pain medications to help the stone pass. If the stone is large or is blocking the flow of urine, the child may require more treatment. We offer the latest in minimally invasive treatment:
- Extracorporeal shock wave lithotripsy (ESWL), in which a machine delivers shock waves that pass through the body and break up the stone into small particles that can be excreted in the urine.
- Ureteroscopy:, in which a flexible scope is passed through the urethra into the urinary tract.
Both ESWL and ureteroscopy leave no scar, offer rapid recovery and are highly effective.
For children with medically complex issues, including renal transplantations or more complex kidney stones, we offer percutanous nephrolithotomy. During this procedure, a small viewing instrument is inserted into the kidney through an incision in the child’s back, and the stone is removed.
All of these procedures are performed under general anesthesia.
What happens after treatment?
Children generally recover quickly from an episode of kidney stones. Children should drink plenty of fluids to keep the urine diluted and to flush away substances that may form stones. To prevent a recurrence, physicians will try to understand why a stone formed. Urine may be collected over a 24-hour period to look for any underlying mineral abnormalities. If the stone has been retrieved, your doctor will analyze its chemical make-up. When an underlying cause can be identified, or if a child has repeated episodes of kidney stones, medications and dietary changes may be recommend to prevent more stones from forming.