Ripa F. et al., 2023: Outcomes of Paediatric Cystine Stone Management: Results of a Systematic Review.

Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
Department of Urology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton, Hampshire, SO16 6YD, UK. 

Abstract

Purpose of review: We wanted to analyse the outcomes of surgical (SWL, URS, PCNL) and medical management of cystine stones in the paediatric population in terms of stone-free status and complication rates, based on all the available literature evidence.

Recent findings: A systematic review of literature was performed for all studies with paediatric cystine stone management. Twelve studies met the eligibility criteria, of which 4 analysed outcomes of SWL, 2 of URS and 3 of PCNL and 3 focused on the effect of either alkalising agents (potassium citrate, citric acid) or cysteine-binding thiol (CBT) agents (tiopronin, penicillamine). The reported SFR in studies ranged from 50 to 83%, 59 to 100% and 63 to 80.6%, with a complication rate of 2.8-51%, 14-27% and 12.9-15.4% with SWL, URS and PCNL, respectively. Paediatric cystine stones treatment should aim at complete stone clearance, preservation of renal function and prevention of further recurrences. SWL achieves inferior results in case of cystine stones. URS and PCNL are safe and effective procedures in the paediatric population, with a low rate of major complications. Adherence to medical prevention therapies may prolong recurrence-free periods.

Curr Urol Rep. 2023 Apr 20. doi: 10.1007/s11934-023-01162-9. Online ahead of print.PMID: 37079195 Review.