Results of shockwave lithotripsy for pediatric urolithiasis

Area of Science:

• Pediatric Urology
• Nephrolithiasis Management
• Extracorporeal Shock Wave Lithotripsy

Background:

• Pediatric urolithiasis management often involves shockwave lithotripsy (SWL).
• Efficacy, ancillary procedure needs, and complications of SWL in children require further definition compared to adults.
• This study reviews SWL outcomes in pediatric patients at a dedicated lithotripsy unit.

Purpose of the Study:

• To evaluate the efficacy and outcomes of SWL in pediatric patients with urolithiasis.
• To identify factors influencing SWL success in children.
• To compare SWL outcomes in pediatric patients with and without risk factors.

Main Methods:

• Retrospective review of 100 pediatric patients (
• Analysis of 115 stones and 131 SWL procedures, including stone characteristics, risk factors, anesthesia, and complications.
• Stone-free status determined by imaging at 3-month follow-up; efficiency quotient (EQ) calculated.

Main Results:

• Risk factors were present in 27% of children; these patients had significantly lower stone-free rates (31.7% vs. 64.7%) after one SWL session (P < 0.001).
• Initial SWL achieved a 60.2% stone-free rate, with a retreatment rate of 13.9%.
• Overall stone-free rate increased to 68% after a second treatment; EQ was 54.3%. Minor complications occurred in 4.6% of patients.

Conclusions:

• Single-session SWL demonstrates moderate efficacy for pediatric urolithiasis based on strict success criteria.
• Pediatric patients with large stones or risk factors (e.g., anatomic abnormalities) are less likely to achieve stone-free status with SWL.
• Endourologic procedures may be a more suitable option for pediatric patients with challenging stone burdens or associated risk factors.