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Published on: August 2, 2024
Pediatric shockwave lithotripsy: size matters!
Pankaj Wadhwa1, Monish Aron, Amlesh Seth
1Department of Urology, All India Institute of Medical Sciences, New Delhi, India. drpwadhwa@yahoo.com
Background And Purpose:
Shockwave lithotripsy (SWL) is a safe and efficacious modality for pediatric urolithiasis. Recent reports claim good results even with larger stone burdens, irrespective of stone location. We reviewed the outcomes of SWL in the pediatric population at our center to assess the impact of stone burden and location and the age of the child on the stone-free rate.
Patients And Methods:
Records of 106 patients
Results:
The overall stone-free rate was 87% (complete clearance 72%; insignificant [<3-mm] residual fragments 15%). The re-treatment rate was 58%, and the efficiency quotient was 47. Whereas stone size correlated strongly with the stone-free rate (Mann-Whitney U test x = 0.004; chi-square test P = 0.02), patient age and stone location did not have a significant impact.
Conclusions:
Extracorporeal shockwave lithotripsy is an effective modality to treat pediatric upper urinary-tract calculi, especially when the stone burden is <200 mm2. Larger stone burdens are associated with poorer results, necessitate more ancillary procedures, and have a higher complication rate.
