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Long-term follow-up after extracorporeal shock wave lithotripsy in children
Insights
Extracorporeal shock wave lithotripsy (ESWL) effectively treated kidney and ureteral stones in children. Long-term follow-up showed most children remained stone-free with normal kidney function and blood pressure.
Area of Science:
- Pediatric Urology
- Nephrology
- Medical Technology
Background:
- Pediatric kidney and ureteral stones pose treatment challenges.
- Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive option for stone removal.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of ESWL in pediatric patients with renal and ureteral calculi.
- To assess stone-free rates, renal function, and blood pressure post-ESWL treatment.
Main Methods:
- Retrospective analysis of 34 children (aged 1-14 years) treated with HM3-Dornier lithotripter.
- Follow-up evaluation included clinical assessment, urinalysis, creatinine levels, blood pressure, radioisotope examinations, and sonography.
Main Results:
- 16 out of 17 children were stone-free at long-term follow-up.
- All evaluated children had normal creatinine levels and negative urinalyses.
- Normal blood pressure was observed in 16/17 children; renal function and kidney size remained within normal limits.
Conclusions:
- ESWL is a safe and effective treatment for pediatric renal and ureteral calculi.
- Long-term outcomes demonstrate high stone-free rates and preservation of renal function and hemodynamics.
Abstract:
In 34 children (25 girls and 9 boys), aged 1-14 years, extracorporeal shock wave lithotripsy (ESWL) was performed for renal and ureteral calculi between March 1985 and December 31, 1989. The patients were treated with the HM3-Dornier lithotripter under general anesthesia. Of the 34 children, 24 with an interval of more than 12 months since ESWL were called in for control check up, 17 of them ultimately came. Seven were lost for long-term follow-up as they moved out of the area. The children were free of urinary symptoms and without urinary tract infections. Creatinine was normal and urinalyses were negative in all 17 children. 16/17 children were stone free and had normal blood pressure, 1 patient with a polycystic kidney on the left nontreated side already demonstrated elevated pretreatment blood pressure. Radioisotope examinations with separate clearance tests gave results in the normal range in 14/17 patients. The sonographic findings on the longitudinal and transverse diameter of the treated and untreated kidneys did not show marked differences as they all remain below the 5% limit.