Urolithiasis in the exstrophy-epispadias complex

R. I. Silver, D. A.C. Gros, R. D. Jeffs, J. P. Gearhart, T. DeJong, R. C. Rink, M. Cendron, H. M. Snyder, G. T. Klauber, H. G.J. Mesrobian, E. Minevich, J. Wacksman, P. K. Reddy, J. W. Brock, J. A. Stock, B. J. Broecker, G. A. McLorie, P. G. Duffy, R. I. Silver, D. A. DiamondM. C. Carr, A. E. Khoury, S. A. Kramer

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Purpose: We sought to determine the incidence of urolithiasis in patients with the exstrophy-epispadias complex, associated risk factors and guidelines for the proper clinical management of this problem. Materials and Methods: We retrospectively reviewed the chart and x-rays of 530 patients with the exstrophy-epispadias complex treated at our institution. Results: Stones formed in 77 of the 530 patients (15%), including 16% of those with classic exstrophy, 25% of those with cloacal exstrophy and 3% of those with epispadias. White and male individuals were most commonly affected. Most calculi formed in the bladder, whether native or augmented by enterocystoplasty. Standard techniques were successful for stone removal. Most calculi consisted of calcium apatite, calcium oxalate monohydrate or magnesium ammonium phosphate, usually in combination with at least I other element. The risk of stone formation was associated with augmentation cystoplasty (p <0.001) and a bladder neck procedure to increase outlet resistance (p <0.001). Other risk factors included urinary tract infection, foreign bodies, vesicoureteral reflux and urinary stasis but not acidosis or immobilization. Stones recurred in 30 patients (39%), including equal numbers of those treated with open and closed techniques, and recurrence was associated with urinary tract infection or struvite composition (p <0.05). Serum calcium abnormalities were not present in any patient, including those with metabolic acidosis or prolonged immobilization. Urinary chemistry studies were incomplete or unavailable. Conclusions: These data suggest that urolithiasis in the exstrophy-epispadias complex is related to risk factors associated with surgical reconstruction of this condition. The role of metabolic abnormalities that may predispose to urolithiasis is unknown but under investigation. Standard treatment is effective but stone recurrence remains a significant problem. Urine chemistry data may provide information to help minimize stone development in this patient population.

Original languageEnglish (US)
Pages (from-to)1322-1326
Number of pages5
JournalJournal of Urology
Volume158
Issue number3 SUPPL.
DOIs
StatePublished - Jan 1 1997

Fingerprint

Epispadias
Urolithiasis
Calculi
Acidosis
Urinary Tract Infections
Immobilization
Urinary Bladder
Calcium
Recurrence
Apatites
Vesico-Ureteral Reflux
Calcium Oxalate
Foreign Bodies
X-Rays
Urine
Guidelines
Incidence
Serum
Population

Keywords

  • Abnormalities
  • Bladder
  • Calculi
  • Epispadias
  • Exstrophy

ASJC Scopus subject areas

  • Urology

Cite this

Silver, R. I., Gros, D. A. C., Jeffs, R. D., Gearhart, J. P., DeJong, T., Rink, R. C., ... Kramer, S. A. (1997). Urolithiasis in the exstrophy-epispadias complex. Journal of Urology, 158(3 SUPPL.), 1322-1326. https://doi.org/10.1016/S0022-5347(01)64467-7

Urolithiasis in the exstrophy-epispadias complex. / Silver, R. I.; Gros, D. A.C.; Jeffs, R. D.; Gearhart, J. P.; DeJong, T.; Rink, R. C.; Cendron, M.; Snyder, H. M.; Klauber, G. T.; Mesrobian, H. G.J.; Minevich, E.; Wacksman, J.; Reddy, P. K.; Brock, J. W.; Stock, J. A.; Broecker, B. J.; McLorie, G. A.; Duffy, P. G.; Silver, R. I.; Diamond, D. A.; Carr, M. C.; Khoury, A. E.; Kramer, S. A.

In: Journal of Urology, Vol. 158, No. 3 SUPPL., 01.01.1997, p. 1322-1326.

Research output: Contribution to journalArticle

Silver, RI, Gros, DAC, Jeffs, RD, Gearhart, JP, DeJong, T, Rink, RC, Cendron, M, Snyder, HM, Klauber, GT, Mesrobian, HGJ, Minevich, E, Wacksman, J, Reddy, PK, Brock, JW, Stock, JA, Broecker, BJ, McLorie, GA, Duffy, PG, Silver, RI, Diamond, DA, Carr, MC, Khoury, AE & Kramer, SA 1997, 'Urolithiasis in the exstrophy-epispadias complex', Journal of Urology, vol. 158, no. 3 SUPPL., pp. 1322-1326. https://doi.org/10.1016/S0022-5347(01)64467-7
Silver RI, Gros DAC, Jeffs RD, Gearhart JP, DeJong T, Rink RC et al. Urolithiasis in the exstrophy-epispadias complex. Journal of Urology. 1997 Jan 1;158(3 SUPPL.):1322-1326. https://doi.org/10.1016/S0022-5347(01)64467-7
Silver, R. I. ; Gros, D. A.C. ; Jeffs, R. D. ; Gearhart, J. P. ; DeJong, T. ; Rink, R. C. ; Cendron, M. ; Snyder, H. M. ; Klauber, G. T. ; Mesrobian, H. G.J. ; Minevich, E. ; Wacksman, J. ; Reddy, P. K. ; Brock, J. W. ; Stock, J. A. ; Broecker, B. J. ; McLorie, G. A. ; Duffy, P. G. ; Silver, R. I. ; Diamond, D. A. ; Carr, M. C. ; Khoury, A. E. ; Kramer, S. A. / Urolithiasis in the exstrophy-epispadias complex. In: Journal of Urology. 1997 ; Vol. 158, No. 3 SUPPL. pp. 1322-1326.
@article{51ce8725f0d9431caa084a843d02a25a,
title = "Urolithiasis in the exstrophy-epispadias complex",
abstract = "Purpose: We sought to determine the incidence of urolithiasis in patients with the exstrophy-epispadias complex, associated risk factors and guidelines for the proper clinical management of this problem. Materials and Methods: We retrospectively reviewed the chart and x-rays of 530 patients with the exstrophy-epispadias complex treated at our institution. Results: Stones formed in 77 of the 530 patients (15{\%}), including 16{\%} of those with classic exstrophy, 25{\%} of those with cloacal exstrophy and 3{\%} of those with epispadias. White and male individuals were most commonly affected. Most calculi formed in the bladder, whether native or augmented by enterocystoplasty. Standard techniques were successful for stone removal. Most calculi consisted of calcium apatite, calcium oxalate monohydrate or magnesium ammonium phosphate, usually in combination with at least I other element. The risk of stone formation was associated with augmentation cystoplasty (p <0.001) and a bladder neck procedure to increase outlet resistance (p <0.001). Other risk factors included urinary tract infection, foreign bodies, vesicoureteral reflux and urinary stasis but not acidosis or immobilization. Stones recurred in 30 patients (39{\%}), including equal numbers of those treated with open and closed techniques, and recurrence was associated with urinary tract infection or struvite composition (p <0.05). Serum calcium abnormalities were not present in any patient, including those with metabolic acidosis or prolonged immobilization. Urinary chemistry studies were incomplete or unavailable. Conclusions: These data suggest that urolithiasis in the exstrophy-epispadias complex is related to risk factors associated with surgical reconstruction of this condition. The role of metabolic abnormalities that may predispose to urolithiasis is unknown but under investigation. Standard treatment is effective but stone recurrence remains a significant problem. Urine chemistry data may provide information to help minimize stone development in this patient population.",
keywords = "Abnormalities, Bladder, Calculi, Epispadias, Exstrophy",
author = "Silver, {R. I.} and Gros, {D. A.C.} and Jeffs, {R. D.} and Gearhart, {J. P.} and T. DeJong and Rink, {R. C.} and M. Cendron and Snyder, {H. M.} and Klauber, {G. T.} and Mesrobian, {H. G.J.} and E. Minevich and J. Wacksman and Reddy, {P. K.} and Brock, {J. W.} and Stock, {J. A.} and Broecker, {B. J.} and McLorie, {G. A.} and Duffy, {P. G.} and Silver, {R. I.} and Diamond, {D. A.} and Carr, {M. C.} and Khoury, {A. E.} and Kramer, {S. A.}",
year = "1997",
month = "1",
day = "1",
doi = "10.1016/S0022-5347(01)64467-7",
language = "English (US)",
volume = "158",
pages = "1322--1326",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "3 SUPPL.",

}

TY - JOUR

T1 - Urolithiasis in the exstrophy-epispadias complex

AU - Silver, R. I.

AU - Gros, D. A.C.

AU - Jeffs, R. D.

AU - Gearhart, J. P.

AU - DeJong, T.

AU - Rink, R. C.

AU - Cendron, M.

AU - Snyder, H. M.

AU - Klauber, G. T.

AU - Mesrobian, H. G.J.

AU - Minevich, E.

AU - Wacksman, J.

AU - Reddy, P. K.

AU - Brock, J. W.

AU - Stock, J. A.

AU - Broecker, B. J.

AU - McLorie, G. A.

AU - Duffy, P. G.

AU - Silver, R. I.

AU - Diamond, D. A.

AU - Carr, M. C.

AU - Khoury, A. E.

AU - Kramer, S. A.

PY - 1997/1/1

Y1 - 1997/1/1

N2 - Purpose: We sought to determine the incidence of urolithiasis in patients with the exstrophy-epispadias complex, associated risk factors and guidelines for the proper clinical management of this problem. Materials and Methods: We retrospectively reviewed the chart and x-rays of 530 patients with the exstrophy-epispadias complex treated at our institution. Results: Stones formed in 77 of the 530 patients (15%), including 16% of those with classic exstrophy, 25% of those with cloacal exstrophy and 3% of those with epispadias. White and male individuals were most commonly affected. Most calculi formed in the bladder, whether native or augmented by enterocystoplasty. Standard techniques were successful for stone removal. Most calculi consisted of calcium apatite, calcium oxalate monohydrate or magnesium ammonium phosphate, usually in combination with at least I other element. The risk of stone formation was associated with augmentation cystoplasty (p <0.001) and a bladder neck procedure to increase outlet resistance (p <0.001). Other risk factors included urinary tract infection, foreign bodies, vesicoureteral reflux and urinary stasis but not acidosis or immobilization. Stones recurred in 30 patients (39%), including equal numbers of those treated with open and closed techniques, and recurrence was associated with urinary tract infection or struvite composition (p <0.05). Serum calcium abnormalities were not present in any patient, including those with metabolic acidosis or prolonged immobilization. Urinary chemistry studies were incomplete or unavailable. Conclusions: These data suggest that urolithiasis in the exstrophy-epispadias complex is related to risk factors associated with surgical reconstruction of this condition. The role of metabolic abnormalities that may predispose to urolithiasis is unknown but under investigation. Standard treatment is effective but stone recurrence remains a significant problem. Urine chemistry data may provide information to help minimize stone development in this patient population.

AB - Purpose: We sought to determine the incidence of urolithiasis in patients with the exstrophy-epispadias complex, associated risk factors and guidelines for the proper clinical management of this problem. Materials and Methods: We retrospectively reviewed the chart and x-rays of 530 patients with the exstrophy-epispadias complex treated at our institution. Results: Stones formed in 77 of the 530 patients (15%), including 16% of those with classic exstrophy, 25% of those with cloacal exstrophy and 3% of those with epispadias. White and male individuals were most commonly affected. Most calculi formed in the bladder, whether native or augmented by enterocystoplasty. Standard techniques were successful for stone removal. Most calculi consisted of calcium apatite, calcium oxalate monohydrate or magnesium ammonium phosphate, usually in combination with at least I other element. The risk of stone formation was associated with augmentation cystoplasty (p <0.001) and a bladder neck procedure to increase outlet resistance (p <0.001). Other risk factors included urinary tract infection, foreign bodies, vesicoureteral reflux and urinary stasis but not acidosis or immobilization. Stones recurred in 30 patients (39%), including equal numbers of those treated with open and closed techniques, and recurrence was associated with urinary tract infection or struvite composition (p <0.05). Serum calcium abnormalities were not present in any patient, including those with metabolic acidosis or prolonged immobilization. Urinary chemistry studies were incomplete or unavailable. Conclusions: These data suggest that urolithiasis in the exstrophy-epispadias complex is related to risk factors associated with surgical reconstruction of this condition. The role of metabolic abnormalities that may predispose to urolithiasis is unknown but under investigation. Standard treatment is effective but stone recurrence remains a significant problem. Urine chemistry data may provide information to help minimize stone development in this patient population.

KW - Abnormalities

KW - Bladder

KW - Calculi

KW - Epispadias

KW - Exstrophy

UR - http://www.scopus.com/inward/record.url?scp=0030877588&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030877588&partnerID=8YFLogxK

U2 - 10.1016/S0022-5347(01)64467-7

DO - 10.1016/S0022-5347(01)64467-7

M3 - Article

C2 - 9258206

AN - SCOPUS:0030877588

VL - 158

SP - 1322

EP - 1326

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 3 SUPPL.

ER -