The Endemic Bladder Stones of Indonesia-Epidemiology and Clinical Features

Abstract

Bladder stone is a relatively common disease of childhood in West Sumatra with an incidence of 8.3/100,000 population per year. We have studied 87 cases with a peak age of onset of 2-4 years and a male/female ratio of 12:1. The majority of these are from poor families with a diet low in protein and phosphate. Diarrhoea is common. The composition of the stones is primarily ammonium acid urate. Patients with sterile urine have shown significantly higher levels of urinary ammonia than controls, and only approximately 50% of patients' urine were infected. This is consistent with excretion of a high acid load, due both to an acidogenic rice diet and diarrhoea, combined with a low level of phosphate. This condition was once endemic in Europe but is now confined to a belt of countries from the Balkans through Asia.

Ammonium acid urate urolithiasis in Japan

“…1,2 On the other hand, endemic AAU urolithiasis is still seen in developing countries, particularly bladder calculi in children. [3][4][5] Although the clinical features and pathophysiology of this type of stone remain unknown, some researchers believe that the etiology is related to a diet high in grain (rice) and low in animal protein. 6 Ordinary Japanese people eat rice as a staple food and live an industrialized lifestyle.…”

Impact of Socioeconomic Status in Etiology and Management of Urinary Stone Disease

“…This is consistent with the excretion of a high acid load due to both an acidogenic rice diet and diarrhea, combined with a low level of phosphate. This condition was once endemic in Europe but is now confined to a belt of countries from the Balkans through Asia [5,7,8].…”

Infrared Spectrometric Analysis of Endemic Bladder Stones in Niger

“…milking of the penis (the latter being almost a diagnostic sign for bladder stones in young boys [2,13,14]). This paper presents a detailed analysis by infrared (IR) spectrometry of 42 bladder stones from young children in Niger.…”