1055 STONE DISEASE IN CHILDREN LESS THAN FIVE YEARS OF AGE: REAL SYMPTOMS, NOT INCIDENTAL FINDINGS

Abstract

You have accessJournal of UrologyPediatrics: Stone Disease1 Apr 20101055 STONE DISEASE IN CHILDREN LESS THAN FIVE YEARS OF AGE: REAL SYMPTOMS, NOT INCIDENTAL FINDINGS Travis Groth and Charles Durkee Travis GrothTravis Groth More articles by this author and Charles DurkeeCharles Durkee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2167AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary calculi in children under five years of age are rare and are not well understood. The incidence of renal stones in the adult and pediatric population appears to be increasing. The widespread use of CT scanning in theory could diagnose asymptomatic urolithiasis in this patient population and create a factitious increase in the incidence of stone disease. We reviewed this subgroup of our urolithiasis database to better define the presentation and characteristics of children less than 5 years of age with urolithiasis. METHODS We reviewed our experience with 28 patients less than five years of age with upper tract urolithiasis over a 12 year period of time at the Children's Hospital of Wisconsin. Data was collected both concurrently at the time of presentation in to our urolithiasis database and with a retrospective chart review. RESULTS Twenty-eight patients were identified. The average age of presentation was 28 months (range 1-63 months). The most common presenting symptoms were hematuria in 13 (46%) and UTI's in 9 (32%) patients. Pain occurred in 9 patients (32%) but was invariably associated with other symptoms. One patient, age 12 months, presented with renal failure due to bilateral obstructing renal calculi with cystine stones. There were no cases where the finding of stone disease was truly serendipitous. Four (15%) of patients presented with ureteral stones. Notably, 23 of the 28 (82%) patients were males, contrasted to our global database of stone patients less than age 18 years of age where 51% were males. A total of 26 ultraousnds, 23 KUB's and 13 CT scans were performed at initial diagnosis. Fourteen (50%) of the patients had associated urinary tract anomalies which contributed to the development of stone formation. Ten (36%) of the patients had significant medical co-morbidities that may have led to urolithiasis formation. The urinary calculi ranged in size from 2-30mm, the average stone size was 7mm and average ureteral stone size was 6mm. CONCLUSIONS Patients less than 5 years of age with urolithiasis present with active symptoms that should lead to the correct diagnosis with appropriate imaging. In this population, urinary tract anatomic anomalies along with medical co-morbidities contributed significantly to the development of stones. Urolithiasis is not an incidental finding in our group of patients who present in early childhood. Milwaukee, WI© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e410-e411 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Travis Groth More articles by this author Charles Durkee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...