Pediatric Urolithiasis in a Rural Tertiary Care Setting: Surgical Strategies and Outcomes

BACKGROUND: Pediatric urolithiasis represents an increasing global health burden, particularly in developing nations. Limited data exist regarding surgical management and outcomes in rural Indian populations. OBJECTIVE: The objective of this study was to analyze the demographic profile, clinical characteristics, surgical interventions, and treatment outcomes of pediatric patients with urolithiasis managed at a rural tertiary care center in North India. MATERIALS AND METHODS: This retrospective observational study reviewed records of 46 consecutive pediatric patients (aged ≤18 years) who underwent surgical intervention for urolithiasis at Uttar Pradesh University of Medical Sciences, Saifai, between January 2017 and December 2024. Data on demographics, stone characteristics, surgical procedures, complications, and outcomes were systematically analyzed. RESULTS: The cohort comprised predominantly adolescent males (mean age: 14.2 ± 3.7 years; 76.1% of male), with 100% rural residence. Renal calculi were most common (60.9%), followed by vesical (15.2%) and ureteral stones (10.9%). Percutaneous nephrolithotomy (PCNL) was the most frequently performed procedure (45.7%), followed by open cystolithotomy (13.0%) and ureteroscopy (10.9%). The overall stone-free rate was 95.7%, with complete clearance in 44 patients. No major intraoperative or postoperative complications occurred. Minor complications (Clavien-Dindo Grade I-II) were observed in 21.7% of cases. The mean hospital stay was 6.8 ± 3.2 days. During a median follow-up of 90 days, no stone recurrence was documented among patients with adequate follow-up (≥3 months). CONCLUSION: Pediatric urolithiasis in rural India predominantly affects adolescent males, with renal stones being most common. Modern surgical techniques, particularly PCNL, achieve excellent stone clearance with minimal morbidity in resource-limited settings. The findings underscore the need for preventive public health strategies and improved healthcare access in rural populations.