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Holmium:YAG lithotripsy in children
T A Wollin1, J M Teichman, V J Rogenes
1Division of Urology, University of Western Ontario, London, Canada.
Insights
Holmium:YAG lithotripsy is a safe and effective treatment for pediatric kidney stones. This study shows high success rates in children, making it a viable option when other treatments fail or are not suitable.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Nephrolithiasis Treatment
Background:
- Pediatric kidney stones require effective and safe treatment options.
- Holmium:YAG (Ho:YAG) laser lithotripsy is a widely used modality for stone fragmentation.
Purpose of the Study:
- To evaluate the safety and efficacy of Ho:YAG lithotripsy in pediatric patients.
- To assess Ho:YAG lithotripsy as an initial or alternative therapy for pediatric stones.
Main Methods:
- Retrospective review of pediatric patients (≤17 years) undergoing Ho:YAG lithotripsy.
- Data collected included demographics, stone characteristics, and procedural outcomes.
- Procedures included retrograde ureteroscopy and percutaneous nephrolithotripsy.
Main Results:
- 19 children (9 boys, 10 girls) with 26 stones were treated.
- 84% of patients achieved a complete stone-free status after one procedure.
- No intraoperative injuries were reported, and follow-up showed no strictures or hydronephrosis.
Conclusions:
- Ho:YAG lithotripsy is a safe and effective treatment for pediatric urolithiasis.
- It serves as a good alternative for cases of failed shock wave lithotripsy or specific stone types/contraindications.
Purpose:
We determined the safety and efficacy of holmium:YAG lithotripsy in children.
Materials And Methods:
We retrospectively reviewed the records of all holmium:YAG lithotripsy done in patients 17 years old or younger. Demographic, preoperative, intraoperative and postoperative data were collected.
Results:
A total of 9 boys and 10 girls (26 stones) with a mean age of 11 years (range 1 to 17) were treated with holmium:YAG lithotripsy, which was chosen as initial therapy in 10 (53%). Retrograde ureteroscopy was performed in 15 patients to treat 13 ureteral and 6 renal calculi, and percutaneous nephrolithotripsy was done in 4 to treat 3 ureteral and 4 renal calculi. A complete stone-free outcome after 1 procedure was achieved in 16 children (84%) and 3 patients were rendered stone-free after 2 procedures. No patient had an intraoperative injury. Followup ranged from 0.5 to 12 months (mean 3). Followup imaging has shown no evidence of stricture or hydronephrosis.
Conclusions:
Holmium:YAG lithotripsy is safe and effective in children. It is a reasonable option for failed shock wave lithotripsy, or in children with a known durile stone composition or contraindications to shock wave lithotripsy.