Monotherapy extracorporeal shock wave lithotripsy for the treatment of staghorn calculi in children

Citation
Hb. Lottmann et al., Monotherapy extracorporeal shock wave lithotripsy for the treatment of staghorn calculi in children, J UROL, 165(6), 2001, pp. 2324-2327
Citations number
20
Categorie Soggetti
Urology & Nephrology","da verificare
Journal title
JOURNAL OF UROLOGY
ISSN journal
00225347 → ACNP
Volume
165
Issue
6
Year of publication
2001
Part
2
Pages
2324 - 2327
Database
ISI
SICI code
0022-5347(200106)165:6<2324:MESWLF>2.0.ZU;2-B
Abstract
Purpose: We evaluate the efficacy and parenchymal consequences of extracorp oreal shock wave lithotripsy (ESWL*) for staghorn calculi in children. Materials and Methods: From 1991 to 1999, 16 young patients 5.5 months to 2 years old and 7 older children 6 to 11 years old were treated for complete (6) or partial (17) staghorn calculi. Infection was the main factor of lit hogenesis, particularly in younger children. In 21 patients the stone burde n was more than 20 mm. All patients were treated under general anesthesia u sing a 14 kV. Sonolith 3000 dagger (14) or a 12 to 20 kV. Nova double dagge r (9) lithotriptor. In 5 of the 7 older children a Double 58 stent was inse rted before treatment. In the younger children group calculi were fragmente d after 1 (11) or 2 (5) sessions. Of the 7 older children 3 required 3 (1) and 4 (2) treatment sessions. To assess the long-term effect of ESWL on the parenchyma, dimercaptosuccinic acid renal scan was performed the day befor e and 6 months after therapy in 20 patients. Results: Of the 16 younger children 14 became stone-free (87.5%) and 2 had small asymptomatic residual fragments, Of the 7 older children 5 were stone -free (71.4%) and 2 required additional surgery. No steinstrasse or pyelone phritis occurred after ESWL and no parenchymal or ureteral lesion related t o ESWL was identified on conventional dimercapto-succinic acid scintigraphy . At a followup of 9 months to 9 years all patients have normal blood press ure. Conclusions: ESWL as a first option is safe and appropriate for the treatme nt of staghorn calculi in children particularly in younger children with in fected calculi.