Extracorporeal shockwave lithotripsy in infants

Area of Science:

• Pediatric Urology
• Nephrology
• Minimally Invasive Surgery

Background:

• Pediatric urolithiasis is uncommon, with limited data on minimally invasive treatments for infants.
• This study details a single-center experience using extracorporeal shockwave lithotripsy (ESWL) for infants with upper urinary tract calculi.

Purpose of the Study:

• To evaluate the efficacy and safety of ESWL for treating upper urinary tract stones in infants.
• To assess short-term and long-term outcomes, including stone-free rates, complications, and recurrence.

Main Methods:

• Seventy-four infants (3-24 months) with upper urinary tract calculi were treated with ESWL.
• Data collected included patient and stone characteristics, risk factors, treatment parameters, and clinical outcomes.
• Follow-up assessments were conducted over a 14.5-year period.

Main Results:

• Successful outcomes were achieved in 97% of infants at 3-month follow-up (88% stone-free, 9% clinically insignificant fragments).
• Retreatment was needed in 35% of patients; 7% required auxiliary procedures, and 3% needed secondary operative procedures.
• Major complications occurred in 7% of patients, including ureteral obstruction and sepsis; long-term follow-up revealed stone recurrence in some, but no significant renal function decline.

Conclusions:

• ESWL is an effective and safe treatment modality for upper urinary tract calculi in infants.
• While short-term complications are infrequent, long-term follow-up is essential for monitoring outcomes and managing potential issues.