A Clinical Study of Urolithiasis in Children

ABSTRACT

PURPOSE: The object of this study was to determine the clinical characteristics of Korean children with urolithiasis. METHODS: From August 1989 to August 1999, 50 patients diagnosed with urolithiasis in a radiologic study were studied retrospectively. We described age, sex distribution, family history, underlying cause, initial symptoms, location of stones, stone analysis and treatment. RESULTS: The total number of patients was 50 cases. Male to fernale ratio was 1.8 and mean age was 6.2+/-4.7 years. Symptoms were hematuria in 23(46%) patients, abdorninal pain in 10(20%), flank pain in 7(14%), fever in 8(16%), dysuria in 1(2%), and incidental in 1(2%). Stones were found in the kidney in 26(52%) patients, ureters in 21(42%), urethra in 1(2%), and kidney and ureter in 2(4%). Hydronephrosis and hydroureter was present in 14(28%) patients, hydronephrosis in 11(22%), vesicoureteral reflux in 2(4%), nonfunctioning kidney in 1(2%), ureterocele in 1(2%), and duplex kidney in 1(2%). Extensive studies, including 24hr urine chemical analysis, were done to find the cause of urolithiasis in 32 patients. Causes were hypercalciuria in 18(56.3%) patients, idiopathic in 9(28.1%), and urinary tract infection in 5(15.6%). Stones were analysed biochemically in 10 patients. Calcium oxalate stones were present in 7 patients, calcium phosphate stones in 1, and struvite stones in 2. Extracoporeal shock wave lithotripsy was performed in most(40%) of the cases, and 26% of the cases passed their stones spontaneously. CONCLUSION: Hematuria is the most common symptom of pediatric urolithiasis. Upper urinary tract is the main site of urolithiasis. The main cause of urolithiasis is hypercalciuria. The main composition of urolithiasis is calcium oxalate.