1984 Volume 75 Issue 10 Pages 1588-1594
We have experienced 24 cases of childhood urolithiasis during 19 years at Tokushima University Hospital. The frequency of childhood urolithiasis ranged from 0 to 3 cases per year, comprising 1.2% of 2080 urolithiatic patients of all ages during the same period. Of the 24 patients, 21 (87.5%) had upper urinary tract stones and 3 had vesical calculi. There were 18 boys and 6 girls with a sex ratio of 3:1. There was no patient under the age of 4 years and 14 patients were between 12-15 years old. The chief complaints were abnormal urine in 9 patients and asymptomatic gross hematuria in 3 patients. Urinary tract infection was found in 12 (50%) patients and proteus species was the predominant bacteria. Factors predisposing stone formation were found in 16 (66.7%) patients. They were metabolic disorders in 9 (37.5%), urinary tract malformation in 4, controlled leukemia in 1 and foreign bodies in 2 patients. The remaining patients included 3 with idiopathic lithiasis and 5 with insufficient metabolic work-up. Seventeen operative procedures including mainly each four of nephrolithotomies, pyelolithotomies and ureterolithotomies were performed on 15 patients, of whom two demonstrated residual stones. Nephrectomy was not done in any case. Stone recurrence was observed in 3 out of 14 patients at more than 1 year after initial therapy (average 63 months). The most common stone component was calcium oxalate.
Compared with other Japanese reports on childhood urolithiasis, three characteristic findings appear to be notable. First, the age incidence was higher in our series and no patient was under 4 years old. Second, metabolic disorders were most frequently found to be the cause of stone formation. Third, no nephrectomy was experienced.
When reviewing the European and American literatures on childhood urolithiasis, the epidemiologic difference can be observed in these two regions and we discussed about it.
