INFECTION STONES IN CHILDREN - A 27-YEAR REVIEW

Objective. The objective of this study was to determine the relationsh ip between urinary tract infection and pediatric urolithiasis and to c haracterize the pediatric infection stone former. Methods. Two hundred seventy consecutive pediatric stone formers presenting over a twenty- seven-year period were studied. Of these, 161 children (60%) had infec tion-related stones. Account was taken of stone composition, anatomic location, associated anatomic lesions, and the rate of stone recurrenc e over a median follow-up of three years. Results. The mean age of chi ldren with infection stones was 4.9 years, with two-thirds being under six years of age. Proteus mirabilis accounted for 82 percent of pure urine cultures. Seventy percent of stones were renal and 30 percent we re ureteral or intravesical. One-third of patients had anatomic lesion s (pelviureteric obstruction, primary obstructed megaureter, and other s) contributing to stone formation. Recurrent stones occurred in 14 pe rcent of cases. Conclusions. This study reaffirms the predominance of urinary tract infection secondary to P. mirabilis as the leading cause of pediatric urolithiasis in the United Kingdom. The significant recu rrence rate suggests the importance of prophylactic antibiotics, surgi cal correction of congenital anomalies, and long-term follow-up of thi s patient population.