[Staghorn calculi of the kidney and ureter as a urologic complication ina child with cerebral palsy].

UNLABELLED: We present a child with cerebral palsy, treated for renal and ureteral staghorn calculi. Calculosis was associated with neurogenic voiding dysfunction.

CASE REPORT: A 10 year boy was admitted to Pediatric Surgery Clinic in Poznań because of urolithiasis. In neurologic examination four-extremities spastic paresis and convergent strabismus was found. Intellectual contact with this child was very poor. Constant urine leakage from urethra was observed. In urine analysis pH < 7, leucocytes and erythrocytes, in urine culture Proteus vulgaris > 10(5). Ultrasonography revealed three staghorn calculi in right kidney. On the plain x-ray film three calculi in right kidney and two staghorn calculi in right ureter. In urodynamic evaluation in cystometry: low bladder compliance, no detrusor overactivity, no bladder sensation, "leak point" pressure 25-27 cm H2O. In profilometry incompetent urethral closure mechanism. All stones were evacuated during one operation. Postoperative course was uneventful. Risk factors in the treatment of patients with cerebral palsy are stressed.

CONCLUSIONS

1. Dysfunction of lower urinary tract is an important clinical problem in children with cerebral palsy. 2. Voiding dysfunction could be a risk factor in the development of urinary stones. 3. In the treatment of children with cerebral palsy multispecialistic team is needed.