Extracorporeal shock wave lithotripsy in children: Results and short‐term complications

Abstract

Aim:The introduction of extracorporeal shock wave lithotripsy represented an important evolution in urinary tract lithiasis management. The aim of this study is to describe the results of extracorporeal shock wave lithotripsy for the treatment of urinary tract lithiasis in children, focusing on the index of elimination of the calculi and the complications occurring during the procedure and during the following three months. Methods: From September 1991 to July 2002, 135 children between one and 12 years, suffering from urinary tract lithiasis underwent extracorporeal shock wave lithotripsy. A retrospective analysis of these patients was carried out. Results: One hundred and ninety-five calculi ranging in size from 5.0 mm to 20.0 mm were treated , out of which 147 were found in the kidneys and 48 in the ureter. Urinary tract dilation was presented by 30% of the children at the time of the procedure. After extracorporeal shock wave lithotripsy 75.8% of the calculi were eliminated: 64.1% were stone-free and 11.7% had Յ 4 mm stones. Ureteral calculi and 5-10 mm stones responded better than the kidney and 11-20 mm stones (P = 0.027 and P = 0.012, respectively). No differences were detected according to the calculi location, whether in the ureter or kidney (P = 0.637 and P = 0.703, respectively). The shock wave intensity of 14kv was as efficient as the higher voltage. Short-term complications were observed in 23.7%, characterized by fever and pain. Conclusion: In children, extracorporeal shock wave lithotripsy proved to be able to eliminate 75.8% of the treated calculi and 83.7% of the patients presented a complete or partial response. Complications were observed in 23.7% of patients, and pain was the most frequent symptom.

Pediatric Extracorporeal Shockwave Lithotripsy: Its Efficiency at Various Locations in the Upper Tract

“…[3][4][5][6][7][8][9][10][11] The majority of these studies used the stone-free rate as the main indicator for treatment success. [3][4][5][6][7] Despite the fact that stonefree status is the ultimate goal of any stone treatment modality, it is important also to measure the Efficacy Quotient (EQ), because it also takes into consideration factors that increase patient's morbidity and anxiousness and result in waste of patient time and hospital resources such as the retreatment rate and the rate of auxiliary procedures. Despite this, only very few studies have reported on the EQ as an important indicator of treatment success in the upper tract urolithiasis.…”

The effect of shockwave lithotripsy on blood pressure, patients’ tolerance to pain and perirenal hematoma in renal stone patients

“…This is consistent with what is reported in literatures. [11,22] In this study there was a significant relation between the size of stone and the development of pain after SWL (P = .003), with larger stones causing more degree of pain after SWL. This finding is supported by Sun et al, and Tiselius et al [10,19] Increasing the energy level did not cause increased risk of developing post SWL pain (P = .65).…”

Litotricia extracorpórea en niños: Eficacia y evaluación a largo plazo de la lesión del parénquima renal mediante gammagrafía con DMSA-99mTc

“…Se ha comunicado en la bibliografía la ausencia de cálculos en el 75 al 92% de los pacientes después de uno a tres tratamientos de LEOC 10,[14][15][16][17][18][19] .…”

“…Todas ellas eran leves y pasajeras, e incluían hematuria, "calle litiásica", obstrucción ureteral e infección urinaria con o sin fiebre 10,15,20 .…”