A review of urinary calculi in children in the Bristol clinical area.

We have undertaken a detailed retrospective study of urinary calculi in the Bristol clinical area from 1950 to 1978. Most calculi in children are detected in the upper urinary tract and the majority are associated with urinary infection. There were two predominant aetiological groups. First the children under 5 years of age, usually male, with a Proteus infection and triple phosphate calculi of the staghorn type in the renal pelvis and calyces. Of the 7 children with a sterile urinary tract in this age group, 4 were discovered to have a metabolic cause for the their calculi. These included 2 patients with cystinuria, 1 with uric acid calculi secondary to the treatment of leukaemia and 1 baby with the adrenogenital syndrome. A second smaller group of children between 8 and 13 years of age presented with ureteric calculi due to calcium oxalate stones in a sterile urinary tract. In the first group the importance of Proteus infections of the urinary tract is emphasised, and possibility of an underlying metabolic abnormality is noted if the urine is sterile. The second group presenting with ureteric colic are no different from adults with "idiopathic" calcium oxalate stones.