Tamsulosin for Ureteral Stones -- Use in a Pediatrics?
Tamsulosin for Ureteral Stones -- Use in a Pediatrics?
Individuals with kidney stones usually present with renal colic symptoms, including flank pain, nausea, vomiting, and/or micro or macroscopic hematuria. Renal colic can be described as waves of severe pain. Typically, the pain is felt in the flank and radiates toward the groin. This type of pain does not change with position and can last from 20 to 60 minutes. The location of pain may correlate with the location of the stone. If the stone is at the level of the ureteropelvic junction, it can cause acute flank pain (Coe, Evan, & Worcester, 2005). If the stone becomes obstruct ed at the urtero-vesical junction, symptoms consistent with a urinary tract infection, including dysuria, urinary frequency, and urinary urgency, occur (Coe et al., 2005; Worcester & Coe, 2008). Children five years of age or younger generally present with a greater stone burden and primarily with renal calculi. In contrast, children between 6 and 18 years of age often present with ureteral stones and have greater spontaneous passage rates (Pietrow, Pope, Adams, Shyr, & Brock, 2002). Stones less than 5 mm usually pass without requiring intervention. Stones larger than 6 mm are often treated with surgical intervention for stone removal, including extracorporal shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy. Ureteral stones that have not passed after two weeks may require surgical intervention due to the increased risk of kidney damage or loss of function in the obstructed kidney; however, before making a decision about treatment, one must take into consideration clinical symptoms, renal function, and expert advice.
Presentation
Individuals with kidney stones usually present with renal colic symptoms, including flank pain, nausea, vomiting, and/or micro or macroscopic hematuria. Renal colic can be described as waves of severe pain. Typically, the pain is felt in the flank and radiates toward the groin. This type of pain does not change with position and can last from 20 to 60 minutes. The location of pain may correlate with the location of the stone. If the stone is at the level of the ureteropelvic junction, it can cause acute flank pain (Coe, Evan, & Worcester, 2005). If the stone becomes obstruct ed at the urtero-vesical junction, symptoms consistent with a urinary tract infection, including dysuria, urinary frequency, and urinary urgency, occur (Coe et al., 2005; Worcester & Coe, 2008). Children five years of age or younger generally present with a greater stone burden and primarily with renal calculi. In contrast, children between 6 and 18 years of age often present with ureteral stones and have greater spontaneous passage rates (Pietrow, Pope, Adams, Shyr, & Brock, 2002). Stones less than 5 mm usually pass without requiring intervention. Stones larger than 6 mm are often treated with surgical intervention for stone removal, including extracorporal shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy. Ureteral stones that have not passed after two weeks may require surgical intervention due to the increased risk of kidney damage or loss of function in the obstructed kidney; however, before making a decision about treatment, one must take into consideration clinical symptoms, renal function, and expert advice.
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