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[Remote lithotripsy with the URAT-P apparatus in treating urolithiasis in children]
Insights
The URAT-P device effectively treated pediatric urolithiasis with high success rates. Remote lithotripsy showed no significant renal functional inhibition, with only minor complications observed.
Area of Science:
- Pediatric Urology
- Nephrology
- Medical Devices
Context:
- Urolithiasis is a significant health concern in children, often requiring surgical intervention.
- Previous treatments for pediatric kidney stones carried risks of complications and functional impairment.
- The URAT-P device offered a non-invasive approach to treating pediatric urolithiasis.
Purpose:
- To evaluate the efficacy and safety of the Soviet-made URAT-P device for remote lithotripsy in pediatric patients.
- To assess the impact of URAT-P lithotripsy on renal function and identify potential complications in children with urolithiasis.
- To determine the optimal treatment conditions for various stone types and sizes in pediatric patients.
Summary:
- The URAT-P device was used for remote lithotripsy in 64 children (22 months to 14 years) with urolithiasis, including those with prior surgeries, hydronephrosis, or pyelonephritis.
- A beneficial effect (complete stone disintegration) was achieved in 98.4% of patients, with most requiring 1-2 sessions. Erosive conditions were used for large/dendritic calculi.
- Post-treatment investigations showed no inhibition of renal functional parameters, and hematuria was transient. Acute pyelonephritis occurred in 6 patients, with one requiring nephrostoma.
Impact:
- The URAT-P device provides a highly effective and safe non-invasive treatment option for pediatric urolithiasis, minimizing the need for surgery.
- This study demonstrates the feasibility of remote lithotripsy in young children, even those with complex stone burdens or prior interventions.
- The findings support the use of URAT-P lithotripsy as a valuable tool in pediatric urology, with a favorable safety profile and high success rates.
Abstract:
The Soviet-made device "URAT-P" for remote lithotripsy was used for the treatment of urolithiasis in children aged from 22 months to 14 years who suffered from various clinical patterns of urolithiasis with solitary or dendritic calculi. Out of 64 treated persons, 21 children had undergone 1-2 surgeries for the disease. The majority of them had pains and frequent aggravations of pyelonephritis. Excretory urography revealed the signs of hydronephrosis and hydrocalycosis. There was no need for additional adjustments to perform the procedure in patients with a height of under 75 cm. The authors employed erosive operating conditions of a shock-wave generator for lithotripsy in case of large or dendritic calculi and to avoid preliminary renal drainage. One treatment session was a success in 43 patients, 2 sessions were needed for 15, 3 for 4 and 4 for 2 patients. A beneficial effect (total disintegration and fragmental discharge) was reached in 64 (98.4%) of the patients. Partial disintegration was recorded only in 1 patient who was exposed to 2 sessions. Radioisotope, immunological, ultrasonic, and biochemical investigations failed to reveal inhibition of the renal functional parameters after remote lithotripsy. No renal injuries associated with hematogenesis were revealed in the parents. The signs of hematuria were observed in the first portion of the postoperative urine only. The only serious complication calling for close attention is acute pyelonephritis observed in 6 patients, one case requiring a surgical application of nephrostoma.