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Ureteral calculi in children: review of 50 consecutive cases
1Department of Urology, Alder Hey Children's Hospital, Liverpool, England.
Insights
This retrospective study of 50 children with ureteral calculi found infection stones were most common, often linked to Proteus species. Recurrences occurred in 6 patients, highlighting the need for ongoing monitoring.
Area of Science:
- Pediatric Urology
- Nephrology
- Infectious Diseases
Background:
- Ureteral calculi in children are uncommon but can lead to significant morbidity.
- Understanding the etiology and characteristics of pediatric ureteral stones is crucial for effective management.
- Previous studies have varied in their focus on stone composition, associated anomalies, and outcomes.
Purpose of the Study:
- To retrospectively analyze the clinical characteristics, etiology, management, and outcomes of pediatric ureteral calculi.
- To identify risk factors for stone recurrence in children.
- To provide data that can inform clinical practice guidelines for pediatric urolithiasis.
Main Methods:
- Retrospective review of 50 children diagnosed with ureteral calculi over a 20-year period.
- Data collected included patient demographics, stone analysis, urine cultures, metabolic workup, and treatment modalities.
- Follow-up data on stone recurrence and complications were analyzed.
Main Results:
- The study included 50 children (35 boys, 15 girls) with a mean age of 5.5 years.
- Infection stones (44/50) were predominant, frequently associated with Proteus species (23/35 infected urine).
- Nineteen patients had urinary tract anomalies, and 6 recurrences were noted within four years.
Conclusions:
- Infection stones are the primary type of ureteral calculi in children, often associated with specific bacterial species and urinary tract anomalies.
- Prompt diagnosis and appropriate management, including addressing underlying infections and anomalies, are essential.
- Long-term surveillance is recommended due to the potential for stone recurrence.
Abstract:
Fifty children presenting with ureteral calculi over a twenty-year period were studied retrospectively. There were 35 boys and 15 girls, with a mean age of five and a half years. Nineteen patients had a urinary tract anomaly: 11 had an obstructed megaureter, and 8 had previously undergone urinary tract surgery. Forty-four children had infection stones and the remaining 6 oxalate calculi. Infected urine was found in 35; the infecting organism was a Proteus species in 23. Metabolic abnormalities were detected in 2 children. Operative removal of the stones was done in 39 patients, and in the remaining 11 patients the stones passed spontaneously. There were 6 recurrences, all within four years of initial presentation.