RESULTS OF EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY IN THE PEDIATRIC AGEGROUP

Objective: In this study we aimed to show the efficacy of extracorpore al shock wave lithotripsy (ESWL) for urinary stone disease in the pedi atric age group and to evaluate the complications encountered after th e treatment. Methods: 67 children with 109 stones underwent ESWL, usin g a Dornier MPL 9000 lithotriptor. Styrofoam boards were used to prote ct the lungs. KUB and chest radiographs were taken on the day after tr eatment. If stone-free status was achieved, the patient was followed w ith ultrasonography and urine analysis every 6 months for 2 years. If fragments <4 mm were present, follow-up was repeated every 3 months. R esults: Stone size ranged from 0.5 to 3.5 cm. 71 renoureteral units un derwent a total of 129 ESWL sessions. Retreatment was required in 28 p atients. The mean number of sessions per unit was 1.8. A stone-free st atus was achieved in 60 renoureteral units. The overall success rate w as 88.6 %. The composition of the stone was mixed calcium oxalate and phosphate in the majority of the patients. Auxiliary procedures used w ere push-back, ureteroscopic stone removal, and open surgery. Hematuri a, colics and fever over 38 degrees C were the complications encounter ed after the treatment. Conclusions: ESWL is the first-line treatment for renal and upper ureteral calculi. However, larger stones which wil l require several ESWL sessions and consecutively increased number of shock waves are best treated with percutaneous nephrolithotomy plus ES WL. Patients with congenital anomalies necessitating surgical reconstr uction are the best candidates for operation.