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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.
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.
Objective:
To study was to identify the variables that influence the outcomes of pediatric SWL patients in our clinic and to compare our findings to previously published nomograms.
Methods:
All children who underwent SWL at a single center between 2005 and 2020 were included in this retrospective study. Depending upon the age and mental state of the children, SWL procedures were performed with or without anesthesia. Data from the hospital information system were obtained on patient characteristics, metabolic evaluation, imaging, SWL details, and post-procedure results, and their correlation with the Onal and Dogan nomograms was evaluated.
Results:
The present study included 112 pediatric patients in total. The average age was 8.22 ± 4.9 (83.3 ± 58.1 months, 4 months-16 years), and the median stone size was 9.5 ± 3.2 mm (4-20 mm). Even though there was quite a significant positive correlation between age and the number of shots and the intensity of shots (intensity and number of shots increased with increasing age), there was no statistical difference in the number of sessions and stone-free rates. The number of shots and sessions was significantly lower in patients with hydronephrosis (N = 70) than in those without (N = 42) (p < 0.001). When the stone-free rates of patients without and with hydronephrosis were compared, it was discovered that they were 69.05% and 92.86%, respectively, which was statistically significant (p < 0.01).
Conclusions:
It is believed that the nomograms developed for SWL in pediatric patients should be reviewed, and larger, prospective studies should be conducted.
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