E. Elsobky et al., Extracorporeal shock wave lithotripsy in children: experience using two second-generation lithotripters, BJU INT, 86(7), 2000, pp. 851-856
Objectives To assess the value of extracorporeal shock wave lithotripsy (ES
WL) in treating paediatric urolithiasis, and to determine factors that may
affect the results.
Patients and methods Using two types of lithotripters (MFL 5000, Dornier Me
dTech GmbH, Germany, and the Echolith, Toshiba Medical Systems, Japan), 148
children and adolescents (mean age 11.2 years, sd 4.7, range 1-18) were tr
eated for urinary stones. Of these, 137 patients had renal stones and 11 ha
d ureteric stones. The respective mean (sd) stone width and length were 10.
2 (4.1) and 12.9 (5.6) mm for renal stones and 7.6 (2.7) and 9.1 (2.7) mm f
or ureteric stones. The patients were assessed 3 months after treatment and
the results compared using the chi-square test to detect factors that migh
t be associated with the stone-free rate.
Results For those with renal stones, the overall stone-free rate was 86% an
d the re-treatment rate 64%. The only significant factor associated with th
e stone-free rate was the transverse diameter of the stone (P = 0.012); the
re was no significant effect of the type of lithotripter but there was a si
gnificant difference in re-treatment rate (P = 0.016) in favour of the MFL
5000. All those with ureteric stones were rendered stone-free and only four
required re-treatment. Only one child among those with renal stones develo
ped steinstrasse; this was managed by ureteroscopy and otherwise no other c
omplications were recorded in either group.
Conclusions ESWL is a safe and effective treatment for paediatric urolithia
sis. The stone-free rate is influenced significantly by stone size. The re-
treatment rate differed significantly between the electrohydraulic and piez
oelectric lithotripters, but the stone-free rate did not.