Association of Vesicoureteric Reflux and Urolithiasis: Single Center Experience in Pediatric Inpatients and Review of the Literature.

OBJECTIVE

To investigate the potential influence of vesicoureteral reflux (VUR) on stone formation in children.

STUDY

DESIGN

A retrospective analysis was conducted on consecutive patients admitted between 2010 and 2023 for either (1) stone treatment (via ESWL or PCNL) or (2) vesicoureteral reflux (VUR). The evaluation included demographic data and, if applicable, the timing and results of voiding cystourethrograms (VCUG). In patients diagnosed with both VUR and stones, a further assessment was performed to analyze potential causality, defined as temporal and spatial co-occurrence, history of UTIs and infection associated stone types (struvite, apatite).

RESULTS

In Group 1 (73 stone patients, mean age 8.8 ± 5.2 years), VUR was diagnosed in 8/31 VCUGs (26 %), primarily low-grade and observed in children under three years of age. Only 2/31 patients (6 %) had VUR coinciding with simultaneous ipsilateral infection stones. In Group 2, among 1758 VUR patients (mean age 3.6 ± 4.0 years), stones were identified in 9 cases (0.5 %), with a likely causal association in 6 of them, corresponding to 1 stone in 300 VUR diagnoses. Additionally, 3 of the 6 children had other risk factors for stone formation or infection.

CONCLUSION

The association between VUR and stone formation appears to be incidental rather than causal. Consequently, the mere presence of a stone should not broaden the indications for a VCUG.