Extracorporeal shock wave lithotripsy in children: experience using two second-generation lithotripters

Citation
E. Elsobky et al., Extracorporeal shock wave lithotripsy in children: experience using two second-generation lithotripters, BJU INT, 86(7), 2000, pp. 851-856
Citations number
29
Categorie Soggetti
Urology & Nephrology
Journal title
BJU INTERNATIONAL
ISSN journal
14644096 → ACNP
Volume
86
Issue
7
Year of publication
2000
Pages
851 - 856
Database
ISI
SICI code
1464-4096(200011)86:7<851:ESWLIC>2.0.ZU;2-8
Abstract
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.