- 作者：Heidi A. Stephany ; Douglass B. Clayton ; Stacy T. Tanaka ; John C. Thomas ; John C. Pope IV ; John W. Brock III ; Mark C. Adams
- 关键词：Myelomeningocele ; Spinal dysraphism ; Nephrolithiasis
- 刊名：Journal of Pediatric Urology
- 出版年：February, 2014
- 年：2014
- 卷：10
- 期：1
- 页码：112-117
- 全文大小：502 K
Objective
Patients with neurogenic bladder are at increased risk of developing upper tract stones. We hypothesized that patients with lower urinary tract stone disease are at greater risk of developing upper tract stones.Methods
We performed a 10-year retrospective case-control study of patients with neurogenic bladder to determine the association between bladder and upper tract stones. Independent risk factors for upper tract stones were assessed. Cases and controls were matched 1:1. Univariable analysis was performed by Fisher's exact test and the Mann-Whitney U test. Multivariable logistic regression was performed.
Results
52 cases and controls were identified. Cases were significantly more likely to be non-ambulatory, have bowel-urinary tract interposition, thoracic level dysraphism, and history of bladder stones. On multivariable analysis, independent predictors of stone formation were male sex (OR 2.82; p聽=聽0.02), dysraphism involving the thoracic spine (OR 3.37; p聽=聽0.014) bowel-urinary tract interposition (OR 2.611; p聽=聽0.038), and a history of bladder stones (OR 3.57; p聽=聽0.015).
Conclusion
Patients with neurogenic bladder are at increased risk for upper tract stones. The presence of bladder stones may herald the development of upper tract stones. The predictors of stone disease identified should guide prospective studies to better understand the natural history of upper tract stone development in this population.