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Treatment of paediatric urolithiasis by extracorporeal shock-wave lithotripsy
D M Wilbert1, O Schofer, H Riedmiller
1Department of Urology, Mainz Medical School, Johannes Gutenberg-University, Federal Republic of Germany.
Insights
Extracorporeal shock-wave lithotripsy is effective for treating pediatric kidney stones. This study shows high stone passage rates and minimal complications in children using two generations of lithotriptors.
Area of Science:
- Urology
- Pediatric Nephrology
Background:
- Non-surgical management of kidney and ureteral stones is established in adults.
- Pediatric nephrolithiasis requires effective and safe treatment options.
Purpose of the Study:
- To evaluate the efficacy and safety of extracorporeal shock-wave lithotripsy (ESWL) in pediatric patients.
- To compare outcomes between first and second-generation lithotriptors for treating pediatric kidney stones.
Main Methods:
- A total of 34 pediatric patients (21 with first-generation, 13 with second-generation lithotriptor) were treated for 47 renal and ureteral stones.
- Complications, stone passage rates, and treatment success were monitored.
Main Results:
- Stone passage rates were high, reaching 93% and 100% in the respective groups.
- Treatment-related complications, including colics and fever, were minimal (17-18.8% and 8.3-6.2%).
Conclusions:
- Extracorporeal shock-wave lithotripsy is a successful non-surgical option for pediatric nephrolithiasis.
- ESWL is effective for limited-size stones in children, with low complication rates.
Abstract:
Non-surgical removal of renal and ureteral stones has proven successful in adults. In this study, 21 paediatric patients have been treated with the first generation extracorporeal shock-wave lithotriptor and an additional 13 children with a second generation local shock-wave lithotriptor. A total of 47 stones was treated. Treatment-related complications such as colics (17%/18.8%) or fever (8.3%/6.2%) were minimal. Stone passage occurred in 93% and 100%, respectively of each group. Open surgery is still the treatment of choice for large staghorn calculi. Extracorporeal shock-wave lithotripsy can be performed successfully in paediatric nephrolithiasis with stones of limited size.