Pediatric low energy lithotripsy with the Lithostar

Area of Science:

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

Background:

• Kidney and ureteral stones in pediatric patients present unique treatment challenges.
• Previous studies have evaluated various lithotripsy methods in children.
• The Siemens Lithostar is a widely used lithotriptor system.

Purpose of the Study:

• To evaluate the safety and effectiveness of low-energy Siemens Lithostar lithotripsy for pediatric renal and ureteral stones.
• To determine success rates, stone-free rates, retreatment rates, and the need for ancillary procedures.
• To assess complication rates associated with the procedure in a pediatric population.

Main Methods:

• A retrospective analysis of 446 pediatric patients treated between November 1988 and July 1993.
• Utilized 26 mobile and 2 fixed Siemens Lithostar lithotriptors.
• Employed the modified Puigvert technique with a standard shock tube.

Main Results:

• For renal stones, the success rate was 76.6%, with a 67.9% stone-free rate and a 14.1% retreatment rate.
• For ureteral stones, the stone-free rate was high at 91.1%, with a low retreatment rate of 3.5%.
• Anesthesia was required in 31% of renal and 21% of ureteral procedures; only one major complication (sepsis) occurred.

Conclusions:

• Low-energy lithotripsy with the Siemens Lithostar is a safe and effective treatment modality for pediatric kidney and ureteral stones.
• The procedure demonstrates favorable stone-free rates and a low incidence of major complications in children.
• This approach offers a viable option for managing nephrolithiasis in pediatric patients.