Pediatric urologyBladder calculi in augmentation cystoplasty in children
Section snippets
Material and methods
Between September 1987 and April 1998, 90 patients underwent surgery in order to obtain a high-volume, low-pressure bladder reservoir by bladder augmentation. The records of 89 patients could be reviewed. Augmentation cystoplasty was performed in 38 male and 51 female patients. The mean age was 14 years with a mean follow-up period of 4.9 years. The mean age at augmentation was 9.5 years (range 9 months to 24 years). The indications for augmentation are given in Table I.
Of the 89 patients, 44
Results
During the follow-up period 18 stones were found in 14 patients for the first time. In Table III different risk factors are listed. In 3 patients more than one type of stone was found at the first presentation with bladder calculi. Ammonium urate and calcium apatite stones occurred only with struvite stones. None of the stoneformers had a history of urolithiasis before augmentation. Two patients, who had had stones prior to augmentation cystoplasty, did not form stones after augmentation. In 1
Comment
Fourteen of our 89 patients formed 18 bladder calculi for the first time following augmentation. Infection stones were encountered most often. It is known that urinary infection, especially with P. mirabilis17 or other urease-producing bacteria, can cause bladder stone formation by changing urine and bladder mucus composition.5 In addition fimbriae, adhesins, and the glycocalyx have been suggested to increase bladder stone formation.18, 19, 20, 21 In this respect measures that remove bacteria
Conclusions
Infections of the augmented bladder are not benign. Girls are more prone to develop stones in enterocystoplasties, despite CIC. It is clear that concomitant surgical procedures, especially on the bladder neck, increase the risk of urolithiasis. Prophylactic use of antibiotics has no effect on the total number of stones, but seems to decrease the number of struvite stones. Congenital malformations and vaginal reconstructions are important risk factors, and we advise guarding against infections.
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Cited by (59)
Long-term outcomes of augmentation cystoplasty: A retrospective view of 54 children
2022, Actas Urologicas EspanolasNeuropathic Bladder and Augmentation Cystoplasty
2018, Urologic Clinics of North AmericaCitation Excerpt :If bladder volume is adequate, autoaugmentation can be considered to help decrease compliance.52 Bladder calculi are the most commonly observed complication observed in 11% to 52% patients following bladder augmentation,47,53–56 and represent the highest risk for additional procedures following augmentation. Calculi typically form in bladders augmented with ileum and/or colon, when absorbable staples are used, in the setting of incomplete bladder emptying, and in patients with a metabolic predisposition for stone formation (eg, hypocitraturia).
Protean and intangible manifestation of renal stones in children
2016, International Journal of SurgeryBladder stones after bladder augmentation are not what they seem
2016, Journal of Pediatric UrologyCitation Excerpt :Therefore, extrapolating these findings to children with augmentation cystoplasty may be inappropriate. Small case series of children with augmented bladders show that a significant proportion of stones are non-infectious [1–4,9–15]. In addition, it is believed that, to date, no published reports exist on the composition of renal calculi in this population.
Bladder calculi in the augmented bladder: A follow-up study of 160 children and adolescents
2015, Journal of Pediatric Urology