Urinary tract anomalies and their role in pediatric stone formation

Ergül R. B., Ozervarli M. F., Oba K. C., Yitgin Y., TEFIK T.

World Journal of Urology, cilt.43, sa.1, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 43 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s00345-025-05962-1
  • Dergi Adı: World Journal of Urology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, Gender Studies Database
  • Anahtar Kelimeler: Ectopic kidney, Lithogenesis, Pediatric nephrolithiasis, Congenital urinary tract anomalies, Exstrophy-epispadias complex, Horseshoe kidney, Minimally invasive surgery, Ureterocele, Ureteropelvic junction obstruction, Urinary stasis
  • İstanbul Üniversitesi Adresli: Evet

Özet

Purpose: This review aims to evaluate the role of congenital urinary tract anomalies in the pathogenesis of pediatric nephrolithiasis. By examining specific structural abnormalities such as ureteropelvic junction obstruction (UPJO), horseshoe kidney, ectopic kidney, exstrophy-epispadias complex, and ureterocele, we aim to elucidate how these anomalies contribute to urinary stasis, infection, metabolic disturbances, and ultimately, stone formation in children. Methods: A narrative literature review was conducted focusing on congenital anomalies of the urinary tract and their association with pediatric stone formation. Relevant studies, case series, and case reports published in peer-reviewed journals were analyzed to explore the pathophysiological mechanisms, diagnostic approaches, and treatment strategies employed in affected pediatric populations. Results: Urinary tract anomalies such as UPJO, horseshoe kidney, and ectopic kidneys were frequently associated with increased risk of stone formation, primarily due to urinary stasis and infection. In UPJO, a significant proportion of patients (up to 76%) also exhibited underlying metabolic abnormalities. Combined surgical approaches, such as robotic or laparoscopic pyeloplasty with simultaneous stone removal, demonstrated favorable outcomes with low complication rates. In children with exstrophy-epispadias complex and bladder augmentation, bladder stones developed in up to 22% of cases, regardless of the bowel segment used. Ureteroceles, although rare in children, can also harbor stones and pose diagnostic challenges. Minimally invasive interventions have shown promising results in these scenarios. Conclusions: Congenital urinary tract anomalies may increase the risk of pediatric stone formation by contributing to urinary obstruction, stasis, and metabolic derangements. While existing evidence supports this association, further prospective studies are needed to better define causality and optimize management strategies in this unique patient population.