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Extracorporeal shock wave lithotripsy in children: experience using a mpl-9000 lithotriptor
Yilmaz Aksoy1, Isa Ozbey, Ali Fuat Atmaca
1Department of Urology, Medical School, Atatürk University, 25240 Erzurum, Turkey. yaksoy@yahoo.com
World Journal of Urology
|January 24, 2004
Summary
Extracorporeal shock wave lithotripsy (ESWL) effectively treats pediatric urolithiasis, with stone size being the key factor for success. This minimally invasive approach is recommended for children to reduce recurrence risk.
Area of Science:
- Pediatric Urology
- Nephrology
- Minimally Invasive Surgery
Background:
- Pediatric urolithiasis requires effective treatment options.
- Recurrence risk is higher in children due to longer disease duration.
- Minimally invasive treatments are preferred for pediatric stone disease.
Purpose of the Study:
- To evaluate the efficacy of extracorporeal shock wave lithotripsy (ESWL) for pediatric urolithiasis.
- To identify factors influencing ESWL treatment success in children.
- To assess the long-term implications of stone disease in pediatric patients.
Main Methods:
- Retrospective analysis of 129 children (134 units) treated with ESWL between 1993-2002.
- Treatment involved a Dornier MPL-9000 lithotriptor under anesthesia/sedation.
- Success defined by absence of fragments on post-treatment imaging; analyzed using chi(2)-tests.
Main Results:
- Overall success rates: 89.5% (pelvic), 85.5% (renal), 75% (ureteral stones).
- Stone diameter was the only significant factor affecting the stone-free rate (P=0.022).
- Complications occurred in 14.7% of patients, including UTIs and Steinstrasse.
Conclusions:
- ESWL is a valuable treatment for pediatric urolithiasis.
- Stone size is a critical determinant of ESWL success in children.
- Minimally invasive ESWL is essential for managing pediatric urolithiasis to prevent recurrences.