Lithostar extracorporeal shock wave lithotripsy in children

Area of Science:

• Pediatric Urology
• Nephrolithiasis Treatment
• Medical Device Technology

Background:

• Pediatric kidney and ureteral stones (calculi) pose unique treatment challenges.
• Minimally invasive techniques are preferred for treating stones in children.
• The Siemens Lithostar lithotriptor is a device designed for stone fragmentation.

Purpose of the Study:

• To evaluate the safety and efficacy of the Siemens Lithostar lithotriptor for treating renal and ureteral calculi in children.
• To determine stone-free rates and overall success rates following lithotripsy.
• To assess the complication profile associated with the procedure in a pediatric population.

Main Methods:

• A cohort of 20 pediatric patients (ages 4-17) with renal or ureteral calculi were treated with the Siemens Lithostar lithotriptor.
• Calculi characteristics including location and size were documented.
• Treatment outcomes were assessed based on stone-free status and residual fragment size at 3 months, with consideration for single versus multiple treatments.

Main Results:

• A total of 34 calculi were treated, located in the renal pelvis (47%), lower calix (29%), upper calix (12%), middle calix (3%), and upper ureter (9%).
• Stone sizes ranged from 2x2 mm to 40x20 mm, averaging 10x7 mm.
• The 3-month stone-free rate was 60% after one treatment, increasing to 80% with multiple treatments. The overall success rate (stone-free or residual fragments ≤4 mm) was 95%.

Conclusions:

• Extracorporeal shock wave lithotripsy (ESWL) with the Siemens Lithostar device is a safe and effective short-term treatment for pediatric renal and ureteral calculi.
• The procedure demonstrated a high success rate and a low incidence of major complications in the studied pediatric cohort.
• ESWL offers a viable therapeutic option for managing nephrolithiasis in children.