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[Extra-corporeal lithotripsy in children]
O Traxer1, H Lottmann, G Van Kote
1Service d'Urologie de l'Enfant et de l'Adolescent, Fondation Hôpital Saint-Joseph, Paris, France. olivier.traxer@tnn.ap-hop-paris.fr
Insights
Extracorporeal shock-wave lithotripsy (ESWL) is effective for pediatric kidney stones, but long-term effects on growing kidneys require further study. This review examines current ESWL practices in children.
Area of Science:
- Pediatric Urology
- Nephrology
- Medical Technology
Context:
- Extracorporeal shock-wave lithotripsy (ESWL) is a standard treatment for adult kidney stones.
- Pediatric use of ESWL has advanced with new technologies, but concerns remain.
- Published pediatric series since 1986 confirm ESWL's efficacy and minimally invasive nature.
Purpose:
- To review the current status of ESWL in pediatric patients.
- To address persistent questions regarding pediatric ESWL, including treatment parameters and long-term effects.
- To synthesize findings from literature, the GEUP report, and clinical experience.
Summary:
- ESWL is a safe and effective treatment for pediatric urolithiasis.
- Second and third-generation lithotripters have improved management of urinary stones in children.
- Key areas for further investigation include optimal shock wave dosage, inter-session intervals, and renal parenchyma effects.
Impact:
- Provides a comprehensive overview of pediatric ESWL, aiding clinical decision-making.
- Highlights areas needing further research to optimize treatment and ensure long-term safety in children.
- Contributes to the understanding of shock wave effects on the developing renal system.
Abstract:
Extracorporeal shock-wave lithotripsy (ESWL) constitutes the reference treatment for renal and ureteric stones in adults, but its use and development in children have been accompanied by a certain degree of caution and reticence. A large number of paediatric series have been published since 1986, confirming the efficacy and minimally invasive nature of this technique. Modification of the nature of the shock waves and release onto the market of second and third generation apparatuses have simplified the management of urinary stones in children. However, several questions persist concerning the maximum number of impacts, the recommended interval between two sessions and the long-term effects of shock waves on the growing renal parenchyma. The objective of this study was to review the current state of ESWL in children based on a review of the literature, the GEUP report and our own experience.
