Fifty-two children with urinary calculi seen between 1975 and 1986 were reviewed. Males dominated the series. The age distribution ranged from 10 months to 14 years (mean 7.2 years); 71% presented after school age. Most patients had upper tract stones. The main presenting symptoms were abdominal pain, infection and haematuria. The causative factors or co-factors were infection, malformations and urodynamic abnormalities. Metabolic disorders were rare. Calcium oxalate and uric acid stones were found most often. Surgical management was required in 88% of patients and only 3.8% had a recurrence. Presenting symptoms are variable and so a high index of suspicion is required for diagnosis.

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SUMMARY Horseshoe kidney anomaly is the result of an embryonic fault occurring between the fourth and eighth week of foetal life. The two renal blastemas become fused before migration and rotation. This accounts for the abnormal relation of the renal pelvis and parenchyma. This review includes twenty–nine cases admitted to the Urological Department, Meath Hospital, Dublin, since 1942. The length of the follow–up varied from three months to twenty–one years. Fifteen cases had one or more surgical procedures and fourteen were treated conservatively. Three cases could not be traced for the follow–up, and two cases died from other diseases after living for six and ten years.

Congenital ureteric valves causing upper urinary tract obstruction was discovered after operation in 4 adults who had presented with different urological problems. The fifth patient, an infant, presented with failure to thrive and was suspected of having a congenital ureteric valve prior to operation. The infant had gross hydronephrosis and was treated by excision of the segment containing the valve and end-to-end anastomosis of the ureter and pyeloplasty because of a narrow pelviureteric junction. Three adults had severe kidney damage and underwent nephrectomy. The fourth adult, who had a horseshoe kidney with 4 small stones in the lowermost calix, underwent pyelolithotomy; in addition, the segment bearing the valve was excised and a ureteropyelostomy was carried out.

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