Bladder calculi in augmentation cystoplasty in children

• Published in: Urology (Ridgewood, N.J.) N.J.), 2000-09, Vol.56 (3), p.482-487
• Main Authors: Mathoera, Rejiv B, Kok, Dik J, Nijman, Rien J.M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Male; Medical sciences; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Sex Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Urinary Bladder - surgery; Urinary Bladder Calculi - etiology; Urinary Bladder Calculi - prevention & control; Urinary Diversion - methods; Urinary Tract Infections - complications
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/S0090-4295(00)00663-4

Objectives. To determine the best preventive strategies for bladder calculi in children with an augmented bladder, the risk factors and prevention strategies for urolithiasis were evaluated. Methods. The records of 89 patients following augmentation cystoplasty were reviewed to assess the results of augmentation cystoplasties and in particular the formation and prevention of calculi. Results. The median follow-up was 4.9 years after augmentation. Most patients (71) had an ileocystoplasty. Bladder calculi occurred in 14 of the 89 patients (16%) and recurred in 4 patients. Girls had a higher incidence of urolithiasis. Other risk factors were cloacal malformations, vaginal reconstructions, anal atresia, clean intermittent catheterization problems and retention, bladder neck surgery, and symptomatic urinary tract infections. Conclusions. Subgroups with cloacal malformations, vaginal reconstructions, ureter reimplantation, and bladder neck surgery were identified that have an increased risk for stone formation and therefore warrant special care in the follow-up after augmentation. This care should include clear emphasis on the role of treating symptomatic urinary tract infections, especially in patients with cloacal malformations and vaginal reconstructions. Girls have a higher incidence of bladder calculi than boys.