Purpose: We determined the safety and efficacy of holmium:YAG lithotripsy i
n children.
Materials and Methods: We retrospectively reviewed the records of all holmi
um:YAG lithotripsy done in patients 17 years old or younger. Demographic, p
reoperative, intraoperative and postoperative data were collected.
Results: A total of 9 boys and 10 girls (26 stones) with a mean age of 11 y
ears (range 1 to 17) were treated with holmium:YAG lithotripsy, which was c
hosen as initial therapy in 10 (53%). Retrograde ureteroscopy was performed
in 15 patients to treat 13 ureteral and 6 renal calculi, and percutaneous
nephrolithotripsy was done in 4 to treat 3 ureteral and 4 renal calculi. A
complete stone-free outcome after 1 procedure was achieved in 16 children (
84%) and 3 patients were rendered stone-free after 2 procedures. No patient
had an intraoperative injury. Followup ranged from 0.5 to 12 months (mean
3). Followup imaging has shown no evidence of stricture or hydronephrosis.
Conclusions: Holmium:YAG lithotripsy is safe and effective in children. It
is a reasonable option for failed shock wave lithotripsy, or in children wi
th a known durile stone composition or contraindications to shock wave lith
otripsy.