How well do ESWL nomograms predict treatment success in pediatric patients?

Basri Çakıroğlu1,2, Ali Gözüküçük3,4, Bekir Sami Uyanik5

  • 1Department of Urology, Hisar Intercontinental Hospital, İstanbul, Turkey.

Urologia
|September 3, 2022
PubMed

Insights

This study analyzed pediatric patients undergoing shock wave lithotripsy (SWL), finding hydronephrosis significantly improves stone-free rates. Age correlates with SWL intensity but not outcomes, suggesting nomogram review for pediatric SWL is needed.

Area of Science:

  • Pediatric Urology
  • Nephrolithiasis Management
  • Extracorporeal Shock Wave Lithotripsy (ESWL)

Background:

  • Pediatric kidney stone treatment relies on effective methods like extracorporeal shock wave lithotripsy (SWL).
  • Established nomograms guide SWL treatment but may require validation in pediatric populations.
  • Understanding factors influencing SWL outcomes in children is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To identify variables impacting pediatric SWL patient outcomes.
  • To compare clinic findings with existing SWL nomograms for pediatric patients.
  • To evaluate the efficacy of SWL in children with and without hydronephrosis.

Main Methods:

  • Retrospective analysis of 112 pediatric patients undergoing SWL between 2005 and 2020.
  • Data collection included patient demographics, SWL parameters, and post-procedure results.
  • Correlation analysis with Onal and Dogan nomograms was performed.

Main Results:

  • Age positively correlated with SWL intensity and number of shots, but not stone-free rates.
  • Patients with hydronephrosis required fewer SWL sessions and had significantly higher stone-free rates (92.86%) compared to those without (69.05%).
  • No statistical difference in the number of sessions and stone-free rates was observed between different age groups.

Conclusions:

  • Hydronephrosis is a positive predictor of successful SWL outcomes in pediatric patients.
  • Current SWL nomograms may need revision for pediatric use.
  • Larger, prospective studies are recommended to refine pediatric SWL treatment guidelines.
Abstract