Diagnóstico y manejo de litiasis renales en adultos y niños

Urinary stones represent an important pathology in urological practice and requires a multidisciplinary approach. Its incidence is close to 10%, affecting a wide range of age groups, with several factors that can influence its incidence in certain places. The stones can be diagnosed as a radiologic finding in routine health checks or during an episode of renal colic, a frequent consultation in emergency services. Its etiology is not completely understood. The most accepted hypothesis involves excretory alterations of the kidney added to environmental factors and habits. The study of patients with urinary stones includes laboratory tests that aim at ruling out complications such as infections and renal insufficiency. The imagenology intends to determine the volume of stones, its location and density to help to decide how to resolve the case, either spontaneously or actively through different types of surgical interventions. Currently, non-enhanced computed tomography is considered the gold standard for diagnosing urinary stones. The treatments are proposed according to the different clinical situations: medical management of renal colic and expulsive therapy for spontaneous resolution of the symptoms; surgical management, where the most frequent techniques are rigid or flexible endoscopic ureterolitectomy extracorporeal shock-wave lithotripsy (ESWL), percutaneous nephrolitectomy (PNL), and finally the etiological study of urinary stones and preventive measures. In pediatric patients, the incidence of urinary lithiasis is lower than in adults, however, the consequences of this disease can be disastrous. The etiology is strongly associated with genetic factors. Currently, the surgical treatments are similar to those practiced in adult patients.