What is the optimal frequency in shock wave lithotripsy for pediatric renal stones? A prospective randomized study

The aim of the study is to compare the effects of varying frequency rates (60, 90, and 120 SWs/min) on the stone free rate and complication rates of pediatric SWL. 75 children with renal stones were divided into 3 groups depending on the SW frequency applied. Group 1. low (60 SWs/min), Group 2. intermediate (90 SWs/min) and Group 3. high (120 SWs/min) frequency. Patient demographics (age, gender, BMI), stone (location, size, laterality), and SWL (total number of sessions, shock waves, anesthesia time) related parameters were documented. Postoperative success, complication rates, and the need for additional interventions were comparatively evaluated. There was no significant difference regarding the patient demographics, stone characteristics, SWL parameters, postoperative complication rates, need for additional interventions as well as efficacy quotient between all (p > 0.05). The stone free rates were significantly lower in cases with high frequency, whereas there was no statistically significant difference between the intermediate and low frequency groups (p > 0.05). Although not statistically significant; low frequency application may be more advantageous than intermediate as lower number of high energy shock waves required which may cause less tissue damage. On the other hand, despite lack of a statistically significant difference, relatively longer anesthesia time may constitute a disadvantage for lower frequency. We believe that considering the growing nature of the child kidney application of low frequency (60 SWs/min) will be advantageous. However, we believe that further studies with larger series of cases are needed to make a clear-cut differentiation between low and intermediate SW applications.