Bladder calculi in augmentation cystoplasty in children

Objectives. To determine the best preventive strategies for bladder calculi in children with an augmented bladder, the risk factors and prevention str ategies for urolithiasis were evaluated. Methods. The records of 89 patients following augmentation cystoplasty were reviewed to assess the results of augmentation cystoplasties and in partic ular the formation and prevention of calculi. Results. The median follow-up was 4.9 years after augmentation. Most patien ts (71) had an ileocystoplasty. Bladder calculi occurred in 14 of the 89 pa tients (16%) and recurred in 4 patients. Girls had a higher incidence of ur olithiasis. Other risk factors were cloacal malformations, vaginal reconstr uctions, anal atresia, clean intermittent catheterization problems and rete ntion, 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 hav e a higher incidence of bladder calculi than boys. UROLOGY 56: 482-487, 200 0. (C) 2000, Elsevier Science Inc.