EAU 2005 - ABST[249] HOW FREQUENT IS VESICOURETERAL REFLUX (VUR) IN CHILDREN WITH STONE DISEASE?
Günay L., Akdogan B., Guliyev F., Inci K., Tekgül S.
Hacettepe University, Urology, Ankara, Turkey
INTRODUCTION & OBJECTIVES: Urolithiasis is known to be related to congenital anomalies of the genitourinary tract including vesicoureteral reflux (VUR).We have studied several parameters of VUR detected in paediatric urolithiasis patients.
MATERIAL & METHODS: Eighty-five children with urinary stones (ages: 1-15 (mean: 5.95; median: 4.15); 34 girls and 48 boys) have undergone voiding-cystourethrography. Several parameters including age, sex, reflux grade, reflux/stone side association, primary complaint at admission, metabolic evaluation, stone size and stone analysis have been studied (mean follow- up:14.25 months).
RESULTS: Nineteen of the 85 (22.4%) patients had VUR (ages: 1-15 (mean: 4.83, median: 4.30); female: 7 (36.8%), male: 12 (63.2%)). Pain, urinary tract infection (UTI) and hematuria appeared to be the primary complaints on admission. However, of the 29 (34.1%) patients whose major complaint was infection on admission, only 9 (31.0%) had VUR and there was no significant correlation between infection and presence of reflux. Of the 28 refluxing renal units, there were stones in 22. In 16 of 28 renal units the reflux and stones were ipsilateral and in 12 of the refluxing ureters stones were on the contra lateral system. Twenty of the 28 renal units had low grade reflux (grade 1-3). There were metabolic problems in 44.4% of the patients and hypocitraturia and hyperoxaluria were the most frequent causes. Calcium stones were the most frequent ones.
CONCLUSIONS: VUR is more frequent in paediatric stone disease patients than normal population. Unlike in primary refluxing patients it is more common in males. Although infection is the foremost complaint and majority of refluxing children with stones do not present with unique symptoms. Usually reflux grade is low. Reflux and stone sides are not correlated. Metabolic problems are also present in refluxing children with stones and rate of metabolic causes is not any different from non-refluxing children with stones. Reflux itself does not seem to be a cause for urinary stone disease, but more likely to be a result.