Bladder stones in children

Although not very frequent in our setting, from time to time we can be confronted by the above problem in very small children. 

Normally it is a disease of the poor classes of the society. In the case of our hospital it is normally a disease of the nomadic populations of the North.

The etiology of the bladder stones is not well understood, but we know it is more frequent in boys than in girls. Kidneys are generally normal.

In the case we report today, we have received a 4-year-old boy from Marsabit area.

He had complained of pain when passing urine for very long time. The uncle escorting him was saying that the child generally pulls his penis as he tries to relieve pain.

The other complains are frequency in passing urine and sometimes hematuria.

The examination of the child was unremarkable, although we noticed that in fact the foreskin of the glans penis was swollen and inflamed from being pulled on.

The patient had been treated many times for urinary tract infection, but he never improved.

I have done a bladder ultrasound and I have noticed a big stone of about 4 cm diameter on the floor of the bladder. The kidneys were normal, as it was the creatinine test as well.

First of all we have tried to insert a catheter in order to rule out the presence of urethral valves. A Foley number 6 Ch was inserted without problem.

We have therefore operated the child, opening his bladder, removing the stone with no difficulty and closing the bladder in 2 layers.

The young patient is now on second day post surgery and he is doing very well.

From our experience and also from literature, it is normally very unlikely for the bladder stone to recur again in the same patient.

Bro Dr Giuseppe Gaido