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Extracorporeal shockwave lithotripsy in the pediatric population
O Demirkesen1, N Tansu, O Yaycioglu
1Department of Urology, Istanbul University, Cerrahpasa School of Medicine, Turkey.
Journal of Endourology
|June 9, 1999
Summary
Shockwave lithotripsy (SWL) effectively treats pediatric urolithiasis, achieving a 93% success rate. This study confirms SWL as a safe and efficient option for childhood kidney stones.
Area of Science:
- Pediatric Urology
- Nephrolithiasis Treatment
- Extracorporeal Shockwave Lithotripsy
Background:
- Childhood urolithiasis is increasingly managed with shockwave lithotripsy (SWL).
- This study reports on the experience and outcomes of SWL in pediatric patients.
Purpose of the Study:
- To evaluate the safety and efficacy of SWL for treating kidney stones in children.
- To assess the stone-free rates and complication incidence in pediatric patients undergoing SWL.
Main Methods:
- Retrospective review of 59 renal units (RU) in 54 pediatric patients treated with Lithostar lithotripter.
- Patients received an average of 2.5 sessions with 1000-2500 shockwaves (14.5-17.8 kV); no routine spasmolytics were used.
- No shielding was employed; lung fields were protected by body positioning for upper pole stones.
Main Results:
- A 93% overall success rate was achieved, with 64% stone-free and 29% having clinically insignificant residual fragments (CIRF).
- The average stone burden was 1.8+/-2.5 cm2, with treatment delivered in outpatient settings.
- One patient required hospitalization for fever; other complications included skin bruising and early hematuria.
Conclusions:
- Shockwave lithotripsy is a safe and effective treatment for pediatric urolithiasis.
- SWL is suitable for childhood stones of appropriate size and radiologic characteristics.
- The high success rate and low complication profile support SWL's role in pediatric stone management.