Development of upper tract stones in patients with congenital neurogenic bladder.
OBJECTIVE
Patients with neurogenic bladder are at increased risk of developing upper tract stones. We hypothesized that patients with lower urinary tract stone disease are at greater risk of developing upper tract stones.


METHODS
We performed a 10-year retrospective case-control study of patients with neurogenic bladder to determine the association between bladder and upper tract stones. Independent risk factors for upper tract stones were assessed. Cases and controls were matched 1:1. Univariable analysis was performed by Fisher's exact test and the Mann-Whitney U test. Multivariable logistic regression was performed.


RESULTS
52 cases and controls were identified. Cases were significantly more likely to be non-ambulatory, have bowel-urinary tract interposition, thoracic level dysraphism, and history of bladder stones. On multivariable analysis, independent predictors of stone formation were male sex (OR 2.82; p = 0.02), dysraphism involving the thoracic spine (OR 3.37; p = 0.014) bowel-urinary tract interposition (OR 2.611; p = 0.038), and a history of bladder stones (OR 3.57; p = 0.015).


CONCLUSIONS
Patients with neurogenic bladder are at increased risk for upper tract stones. The presence of bladder stones may herald the development of upper tract stones. The predictors of stone disease identified should guide prospective studies to better understand the natural history of upper tract stone development in this population.
Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 4102 Doctors' Office Tower, 2200 Children's Way, Nashville, TN 37232-9820, USA. Electronic address: heidi.stephany@gmail.com.
Heidi A
HA
Stephany
Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 4102 Doctors' Office Tower, 2200 Children's Way, Nashville, TN 37232-9820, USA. Electronic address: douglass.b.clayton@vanderbilt.edu.
Douglass B
DB
Clayton
Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 4102 Doctors' Office Tower, 2200 Children's Way, Nashville, TN 37232-9820, USA. Electronic address: stacy.tanaka@vanderbilt.edu.
Stacy T
ST
Tanaka
Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 4102 Doctors' Office Tower, 2200 Children's Way, Nashville, TN 37232-9820, USA. Electronic address: john.thomas@vanderbilt.edu.
John C
JC
Thomas
Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 4102 Doctors' Office Tower, 2200 Children's Way, Nashville, TN 37232-9820, USA. Electronic address: john.pope@vanderbilt.edu.
John C
JC
Pope
Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 4102 Doctors' Office Tower, 2200 Children's Way, Nashville, TN 37232-9820, USA. Electronic address: john.brock@vanderbilt.edu.
John W
JW
Brock
Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 4102 Doctors' Office Tower, 2200 Children's Way, Nashville, TN 37232-9820, USA. Electronic address: mark.adams@vanderbilt.edu.
Mark C
MC
Adams
D000293:Adolescent; D000328:Adult; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D001744:Urinary Bladder Calculi / Q000453:epidemiology; D001750:Urinary Bladder, Neurogenic / Q000151:congenital / Q000453:epidemiology*; D014545:Urinary Calculi / Q000453:epidemiology*; D055815:Young Adult
Myelomeningocele; Nephrolithiasis; Spinal dysraphism