Extracorporeal shock wave lithotripsy in the pediatric population

Following the successful introduction for treatment of urolithiasis in adults in the early 1980s, shock wave lithotripsy (SWL) rapidly became a standard treatment for children with urolithiasis as well. SWL in children results in stone-free rates of 60-80% with contemporary equipment. Complication rates appear to be very low, although long-term risks remain uncertain. Laboratory studies in animal studies have identified deleterious effects of shock waves on renal tissue, and some have suggested that the immature or developing kidney may be more susceptible to such effects. However, clinical studies in pediatric human patients treated with SWL have not consistently identified serious long-term consequences of SWL. Therefore, despite advances in endoscopic equipment and techniques that facilitate endourologic management of pediatric urolithiasis, SWL continues to be an apparently safe and effective option in children with stones.