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Results of extracorporeal shock wave lithotripsy in young children
1Department of Urology, Al-Azhar University, Cairo, Egypt.
Insights
Extracorporeal shock wave lithotripsy (ESWL) effectively treated upper urinary tract stones in 42 children aged 3-8 years. This pediatric application of ESWL achieved an 85% stone-free rate with modifications to the lithotripter.
Area of Science:
- Pediatric Urology
- Nephrolithiasis Treatment
- Medical Device Engineering
Background:
- Extracorporeal shock wave lithotripsy (ESWL) is a common treatment for kidney stones.
- Pediatric application of ESWL requires specific considerations due to patient size and anatomy.
- Previous studies on pediatric ESWL have varied in outcomes and methodologies.
Purpose of the Study:
- To evaluate the efficacy and safety of ESWL in treating upper urinary tract calculi in children.
- To describe technical modifications necessary for pediatric treatment using the Dornier HM-3 lithotripter.
- To determine the stone-free rate in pediatric patients following ESWL.
Main Methods:
- Retrospective analysis of 42 pediatric patients (age 3-8 years) treated between 1985-1988.
- Patients had upper urinary tract calculi (0.8-2.5 cm) treated with Dornier HM-3 lithotripter.
- Technical modifications were made to the gantry chair for pediatric treatment; shock wave parameters were standardized (≤900/session at 18 kV).
Main Results:
- A total of 51 treatment sessions were performed in the 42 children.
- The stone-free rate at 3-month follow-up was 85%.
- No adverse events or complications were detailed in the abstract.
Conclusions:
- Modified extracorporeal shock wave lithotripsy is an effective treatment for upper urinary tract stones in young children.
- The Dornier HM-3 lithotripter can be adapted for pediatric use, achieving high stone-free rates.
- ESWL offers a viable, non-invasive option for pediatric nephrolithiasis.
Abstract:
Between 1985 and 1988, 2,200 patients were treated at our institution by extracorporeal shock wave lithotripsy. Forty-two children were included in this group and ranged in age from 3-8 years. Weight and height range was 13-28 kg and 82-126 cm, respectively. In order to treat children in this height and weight range some technical changes had to be made to the gantry chair of the Dornier HM-3 lithotripter. All children had upper urinary tract calculi with stone size ranging from 0.8-2.5 cm. The total number of treatments in these 42 children was 51, and the number of shock waves did not exceed 900 per session at 18 kV. A stone-free rate of 85% was achieved at 3-month follow-up.