OBJECTIVE: To define the epidemiological and clinical characteristics of urinary stones in infants, to study the role of stone chemical analysis in the aetiological assessment of urinary stones and to define the various treatment modalities adapted to this age-group. PATIENTS AND METHODS: Between 1984 and 2002, 64 infants (age: 5-24 months) were hospitalised for urinary stones. Urine culture was performed in all patients and metabolic assessment was performed in 24 patients. Physicochemical stone analysis was performed by infrared spectrophotometry in 37 patients. RESULTS: Upper tract and lower tract stones were equally prevalent. Urine culture was positive in 48 cases. The micro-organism most frequently isolated was Proteus mirabilis (19 cases). The metabolic assessment was normal in 15 patients and pathological in 9 patients. Infrared spectrophotometry showed that 17 stones were pure. 60 patients were treated surgically, 2 were treated by endoscopy associated with intracorporeal lithotripsy. One patient was treated medically and another patient passed the stone spontaneously while in hospital. No intraoperative or postoperative complication was observed. No recurrence was observed in this series. The mean follow-up is 16 months (range: 6 months to 94 months). CONCLUSION: The epidemiological profile of urinary stones in infants in Tunisia is situated between that observed in developed countries and that observed in developing countries. In our study, the incidence of metabolic abnormalities appears to be low despite a high rate of consanguinity in Tunisia. This can be largely explained by the absence of an aetiological survey and/or an inadequate survey when it is performed.
OBJECTIVE: To define the epidemiological and clinical characteristics of urinary stones in infants, to study the role of stone chemical analysis in the aetiological assessment of urinary stones and to define the various treatment modalities adapted to this age-group. PATIENTS AND METHODS: Between 1984 and 2002, 64 infants (age: 5-24 months) were hospitalised for urinary stones. Urine culture was performed in all patients and metabolic assessment was performed in 24 patients. Physicochemical stone analysis was performed by infrared spectrophotometry in 37 patients. RESULTS: Upper tract and lower tract stones were equally prevalent. Urine culture was positive in 48 cases. The micro-organism most frequently isolated was Proteus mirabilis (19 cases). The metabolic assessment was normal in 15 patients and pathological in 9 patients. Infrared spectrophotometry showed that 17 stones were pure. 60 patients were treated surgically, 2 were treated by endoscopy associated with intracorporeal lithotripsy. One patient was treated medically and another patient passed the stone spontaneously while in hospital. No intraoperative or postoperative complication was observed. No recurrence was observed in this series. The mean follow-up is 16 months (range: 6 months to 94 months). CONCLUSION: The epidemiological profile of urinary stones in infants in Tunisia is situated between that observed in developed countries and that observed in developing countries. In our study, the incidence of metabolic abnormalities appears to be low despite a high rate of consanguinity in Tunisia. This can be largely explained by the absence of an aetiological survey and/or an inadequate survey when it is performed.
Authors: Isso Ouédraogo; Aïcha Madina Napon; Emile Bandré; Francis Somkieta Ouédraogo; Wendlamita Toussaint Tapsoba; Albert Wandaogo Journal: Pan Afr Med J Date: 2015-04-14