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Electromagnetic extracorporeal shock wave lithotripsy in children
H Vandeursen1, P Devos, L Baert
1Department of Urology, University Clinic Sint-Pieter, Catholic University of Leuven, Belgium.
The Journal of Urology
|June 1, 1991
Summary
Extracorporeal shock wave lithotripsy (ESWL) effectively treated pediatric urinary tract stones in 28 children. This safe and efficient method achieved a 90.5% stone-free rate with minimal complications.
Area of Science:
- Pediatric Urology
- Nephrolithiasis Treatment
- Medical Device Technology
Background:
- Urinary tract calculi in children pose treatment challenges.
- Minimally invasive options are preferred for pediatric stone disease.
Purpose of the Study:
- To evaluate the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) for treating urinary tract calculi in children.
- To assess the stone-free rates and complication profiles associated with ESWL in a pediatric cohort.
Main Methods:
- ESWL was performed on 28 children (42 calculi in 30 renal units) using a standard Siemens Lithostar device.
- Treatments involved an average of 3,188 shock waves at 16.4 kV, with a mean fluoroscopy time of 1.5 minutes per session.
- General anesthesia was utilized in 52% of sessions to ensure patient immobility.
Main Results:
- A complete stone-free rate of 90.5% (38/42 calculi) was achieved.
- Success rates were 71.4% after one session, 13.7% after two, and 4.8% after three sessions.
- Two cases of staghorn calculi required multiple sessions with residual fragments, and one cystine staghorn stone necessitated open surgery; one ureteral stone required laser lithotripsy.
Conclusions:
- Electromagnetic ESWL with the standard Lithostar unit is a safe and effective monotherapy for pediatric urinary tract calculi.
- The procedure demonstrated a high stone-free rate with no significant intraoperative or postoperative complications.
- ESWL offers a viable, minimally invasive treatment option for children with various types of urinary stones.