الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Nowadays, urolithiasis in childhood is rare in the developed world; it represents 1% to 5% of all urinary tract stones, and moreover, urinary bladder stone is very rare. At the same time, in the developing countries, the occurrence of pediatric urolithiasis is 30% of all urinary tract stones, and the so-called endemic bladder stone is still common in the childhood. In the developed countries, the main component of the rarely existing urinary bladder stones is struvite; at the same time, in the developing world, the main component is ammonium acid urate. The pathogenesis and biochemical explanation of endemic stone formation remain unclear, but it seems that there is a correlation between stone formation and malnutrition, low animal protein intake, and vitamin A deficiency. The common practice in endemic areas is feeding infants with human breast milk, which, in contrast to cow’s milk, is low in phosphorus. Such low-phosphate diets result in high peaks of urinary ammonia excretion. Infection remains a major aetiological factor, particularly in boys, but the proportion of affected children with an underlying biochemical predisposition appears to be increasing. For this reason, metabolic evaluation is essential for every child. The rate of stone recurrence is lower in children compared with adults. There are too many factors involved in stone formation such as: urinary concentration, ionic activity and solubility of stone-forming constituents, presence of abnormal urinary metabolites or pathologically elevated concentration of normal urinary constituents, urinary infection, anatomical abnormalities of the urinary tract, foreign materials, prematurity. As regards the aetiology there are two clinical aspects: infective calculi and metabolic calculi (calcium, oxalate, cystine, uric acid and xanthine). As regards underlying urological conditions it was found that predisposing urological abnormalities can be identified in approximately 20-30% of children with urinary calculi, a far higher figure than in adults. Children with stone disease varies in there clinical presentation regarding the age at presentation and the complain Regarding the age factor stones may develop from as early as 2-3 months of life. In children, there is a higher prevalence in early childhood (less than 5 years), predominantly due to an excess of infective stones secondary to urinary tract infection. The main clinical presentations are urinary infection, haematuria, passage of stone material per urethram, abdominal mass and pain (acute renal colic of the pattern and severity encountered in adults is not a prominent feature of the symptomology in children). Additional investigations are to be considered: micturating cystography, dynamic renography, metabolic investigations and stone screening. Open surgery (cystolithotomy) remains the preferred option for very large stones, particularly those forming within augmented bladders. where the bladder neck has been formally closed in conjunction with augmentation and the creation of a Mitrofanoff stoma, open cystolithotomy is the simplest and most effective surgical option.
Objectives: The aim of the work is to review sufficient data and information about urinary bladder stones in pediatric patients that would be helpful in increasing awareness about the disease; in order eventually to eliminate this problem for a better future for our children.