Evolution of diagnostic tactics and microbiological profile in pediatric nephrolithiasis
Received: 2026-10-05
Published: 2026-03-30
Abstract
Background: The introduction of mini-percutaneous surgery for nephrolithiasis requires detailed preoperative visualization, while the high incidence of infections dictates the need for microbiological background assessment.
Objective: To track the transformation of the diagnostic algorithm over 8 years in a specialized center and characterize urine microflora based on the urease activity of pathogens.
Materials and Methods: A data analysis of 144 children aged from 6 months to 18 years, operated between January 2018 and April 2026, was conducted. Patients were divided into traditional intervention (2018–2022, n=76) and mini-percutaneous nephrolithotomy (2023–2026, n=68) cohorts. Radiological imaging parameters and bacteriological cultures were evaluated.
Results: Ultrasound maintained its status as the primary screening tool with 100% coverage. The application rates of plain radiography and excretory urography decreased by 5.5 and 2.3 times respectively, whereas the use of multispiral computed tomography increased by 13.6 times for stone density assessment. Bacteriuria was diagnosed in 43.1% of patients, with 43.5% of isolates exhibiting urease activity, predominantly Proteus mirabilis (19.4%).
Conclusion: The transition to minimally invasive surgery shifts the priority towards tomography. A significant proportion of urease-producing flora acts as a direct catalyst for lithogenesis, demanding mandatory antibacterial sanitation before surgery.
Keywords
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