1981 Volume 72 Issue 3 Pages 288-295
During the last 15 years (1965.1-1979.12), we have experienced 17 cases of urolithiasis in children under 15 years of age. Childhood urolithiasis was rare and occupied 1.6% of 1047 urolithiasic patients of all ages during the same periods. There were 12 boys and 5 girls. The sex ratio was 2.4 to 1. The youngest case was 8 month-old and the eldest was 15 year-old. Eight cases (47%) were under 5 years-old. Thirteen patients had stones in the upper urinary tract (9 in the kidney and 4 in the ureter), 2 in the lower tract (2 in bladder) and 2 in both upper and lower tracts (1 in the ureter and bladder, 1 in the ureter and urethra), respectively. Signs and symptoms were gross total hematuria in 6 cases, fever in 3, flank pain in 3, vesical irritation in 3, urinary retension in 1 and urinary incontinence in 1. Thirteen operations were performed in 11 patients with stones in the upper urinary tract. The nephrectomy was done in two patients and the kidney was conserved in 9 patients. Ten stones were analysed by infrared spectrography. There were 4 phosphate containing calculi, 3 oxalate containig ones, 2 cystine stones and 1 xanthine stone. Predisposing factors for stone formation were assumed in 9 cases (52.9%): Cystinuria in 2 cases xanthinuria in one case, urinary tract obstructions and/or infections in 3 cases, side effects of drugs administered to underlying, diseases in 2 cases and long-term immobilization in one case. Of 12 cases successfully treated to the stone free conditions, only one patient recurred the stone during the follow-up period of averaging 9.6 years. The recurrence rate was 8.3%, which was significantly lower than those of adult cases. A complete urographic study is necessary for early diagnosis of pediatric urolithiasis. Abdominal CT scan may be of great help in the case of X-ray negative stones. A thorough search for predisposing factors is important in children, since metabolic disorders and urinary tract obstructions are prevalent in pediatric urolithiasis.
