PEDIATRICS Vol. 87 No. 4 April 1991, pp. 445-450
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Childhood Urolithiasis: Experiences and Advances

John P. Gearhart MD1, Gilbert Z. Herzberg MD1, and Robert D. Jeffs MD1

1 From the Division of Pediatric Urology, Department of Urology, James Buchanan Brady Urological Institute, The Johns Hopkins Hospital and Children's Center, Baltimore, Maryland

Between June 1979 and June 1989, 54 children with urolithiasis were evaluated and treated at the Johns Hopkins Children's Center. The most common symptoms were flank or abdominal pain (58%) and gross hematuria (28%). In 46 children (86%), stones were secondary to a preexisting condition and in only 8 (14%) no apparent cause of stone formation could be found. Thirty-six patients (66%) had a solitary stone, most commonly found in the kidney. Urinary tract infections were present in 25 (47%) of the patients who had stones. Stones composed either of calcium oxalate or struvite were the most frequently recovered in these patients with infections. Twenty-one patients (39%) spontaneously passed their stones whereas 23 (43%) required either surgery or extracorporeal shock-wave lithotripsy to resolve stones. Ten (20%) showed recurrence of their urolithiasis, with follow-up examination periods ranging from 1 month to 10 years. Recent advances in the management of urolithiasis and their applicability to the pediatric population are discussed.

Key Words: stones • urolithiasis • obstructive uropathy

Submitted on March 9, 1990
Accepted on May 15, 1990




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