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urinary crystals

About 3 months ago my son who is 12 started wetting the bed after being dry 10 years and complaning of pain when he urinates.  He had a vcug, cystegram, CT, MRI, ultrasounds, urinalsis.  In the urologist office my son had 4 oz of urine left after voiding.  After all this he couldn't come up with anything.  We even consider sexually abuse.  Finally his Ped. redid an urinalsis which all of the where negative, except the last one which had crystals in it.  The doctor told me that that just meant that there was a change in the process, and sent us to our states children hospital.  There the Ped urologist did another ultrasound and said he had about 8oz left after voiding.  She said that his problem is that he has been holding his urine for to long to long and but him on a voiding schedule every 2 hours.  This has seemed to help the pain.  She also said that concerning the crystals that some people just spill calcium over into their urine.  Is there something else that might be involved.  This explaintion was to short for me.  Am I just making to much of the crystals or should they be looked into further.
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Kidney stones, uric acid stones, as well as xanthinuria can all be considered for the crystals in the urine.  

Xanthinuria is the urinary excretion of the purine base xanthine.  This is normally caused by a hereditary disorder.  This can occur in children as young as 10 years in age.

Lab tests include a 24-hr urine test, blood tests looking for kidney dysfunction, as well as more specific tests looking for  xanthine and hypoxanthine blood levels.  You already have had many imaging tests, which would evaluate for the more serious causes.  

Another more specialized test would be an allopurinol challenge test, which can be discussed with your urologist.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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