PURPOSE: We determined the long-term prognosis of the pediatric patient presenting with simultaneous ureteropelvic junction obstruction and a renal calculus. MATERIALS AND METHODS: We retrospectively reviewed all individuals younger than 17 years who presented to our institutions with simultaneous ureteropelvic junction obstruction and an ipsilateral renal calculus. RESULTS: Simultaneous ureteropelvic junction obstruction with nonstruvite calculi was present in 22 patients, while 6 had struvite calculi. Median age at diagnosis was 11 years (range 5 to 16). During a median followup of 9 years (range 2 to 38) renal calculi recurred in 19 patients (68%), including 10 (36%) with 1 and 9 (32%) with 2 or more recurrences. Median time to first stone recurrence was 11 years (range 2 to 38). Of the 22 patients with nonstruvite calculi 15 (68%) had recurrence. An identifiable metabolic etiology for renal lithiasis was found in 13 of these patients (87%). In contrast, only 2 of the 7 patients (29%) with nonstruvite calculi and no recurrent stones had an identifiable abnormality. This finding suggests that the presence of an identifiable metabolic abnormality significantly predisposes to recurrent nonstruvite renal lithiasis (p < 0.01). CONCLUSIONS: Of the pediatric patients presenting with simultaneous ureteropelvic junction obstruction and a renal calculus 68% will have recurrent renal lithiasis. It remains to be determined whether active treatment of coexisting metabolic abnormalities could prevent or reduce the incidence of recurrent stone disease.
PURPOSE: We determined the long-term prognosis of the pediatric patient presenting with simultaneous ureteropelvic junction obstruction and a renal calculus. MATERIALS AND METHODS: We retrospectively reviewed all individuals younger than 17 years who presented to our institutions with simultaneous ureteropelvic junction obstruction and an ipsilateral renal calculus. RESULTS: Simultaneous ureteropelvic junction obstruction with nonstruvite calculi was present in 22 patients, while 6 had struvite calculi. Median age at diagnosis was 11 years (range 5 to 16). During a median followup of 9 years (range 2 to 38) renal calculi recurred in 19 patients (68%), including 10 (36%) with 1 and 9 (32%) with 2 or more recurrences. Median time to first stone recurrence was 11 years (range 2 to 38). Of the 22 patients with nonstruvite calculi 15 (68%) had recurrence. An identifiable metabolic etiology for renal lithiasis was found in 13 of these patients (87%). In contrast, only 2 of the 7 patients (29%) with nonstruvite calculi and no recurrent stones had an identifiable abnormality. This finding suggests that the presence of an identifiable metabolic abnormality significantly predisposes to recurrent nonstruvite renal lithiasis (p < 0.01). CONCLUSIONS: Of the pediatric patients presenting with simultaneous ureteropelvic junction obstruction and a renal calculus 68% will have recurrent renal lithiasis. It remains to be determined whether active treatment of coexisting metabolic abnormalities could prevent or reduce the incidence of recurrent stone disease.
Authors: Brian R Matlaga; Nicole L Miller; Colin Terry; Samuel C Kim; Ramsay L Kuo; Fredric L Coe; Andrew P Evan; James E Lingeman Journal: Urol Res Date: 2007-02-02
Authors: Juan Gómez Rivas; Sergio Alonso Y Gregorio; Leslie Cuello Sánchez; Cristina de Castro Guerin; Angel Tabernero Gómez; Luis Hidalgo Togores; Jesús Javier de la Peña Barthel Journal: Cent European J Urol Date: 2014-01-27