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Extracorporeal shock wave lithotripsy in children: experience with the multifunctional lithotripter MFL 5000
1Department of Urology, Cathay General Hospital, Taipei, Taiwan, R.O.C.
Insights
Extracorporeal shock wave lithotripsy (ESWL) effectively treats pediatric urinary tract stones. This study shows ESWL is safe and successful for children with kidney, ureter, and bladder calculi.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Technology
Background:
- Urinary tract calculi (stones) are common in children.
- Extracorporeal shock wave lithotripsy (ESWL) is established for upper tract stones.
- Limited data exists on ESWL for pediatric lower urinary tract calculi.
Purpose of the Study:
- To evaluate the safety and efficacy of ESWL for pediatric urolithiasis.
- To assess ESWL outcomes in children with stones in the renal pelvis, lower ureter, and bladder.
Main Methods:
- Nine pediatric patients (aged 1-18 years) with urolithiasis were treated.
- Dornier MFL 5000 lithotripter was used.
- Polystyrene plates protected younger children; prone positioning was used for lower tract stones.
Main Results:
- Excellent stone pulverization in 8 out of 9 cases.
- One case required secondary cystolithotripsy for residual bladder fragments.
- No gastrointestinal complications, melena, or hemoptysis were reported.
Conclusions:
- Extracorporeal shock wave lithotripsy (ESWL) is a safe and effective treatment for pediatric urolithiasis.
- ESWL can be successfully applied to stones in the renal pelvis, lower ureter, and bladder in children.
- Modified techniques, including prone positioning, enhance ESWL effectiveness in pediatric lower urinary tract calculi.
Abstract:
Extracorporeal shock wave lithotripsy (ESWL) has been proved to be an effective method of treating upper urinary tract calculi. However, there is little experience with the use of this approach in pediatric urolithiasis, especially for lower urinary tract calculi. Nine children, aged 1-18 years, were treated here with urolithiasis in the renal pelvis, lower ureter and bladder, using Dornier MFL 5000. A polystyrene plate was used to protect small children from chest damage. Prone position was routinely used to treat lower ureteral and vesical calculi, thus avoiding bony pelvis blockage of shock wave energy. Excellent pulverization was achieved in eight cases; fragmentation in only one case, then required cystolithotripsy for bladder stone fragments three months after ESWL. No patient had melena. Neither hemoptysis nor gastrointestinal complications were seen. Extracorporeal shock wave lithotripsy is a safe and effective method of treating urinary tract calculi in children.