Literature DB >> 18727616

Extracorporeal shock wave lithotripsy in children: equivalent clearance rates to adults is achieved with fewer and lower energy shock waves.

Abraham Kurien1, Stephanie Symons, Thimmegowda Manohar, Mahesh Desai.   

Abstract

OBJECTIVE: To compare the outcome, safety and efficiency of extracorporeal shock wave lithotripsy (ESWL) using an electromagnetic lithotripter for upper urinary tract stones in children and adults. PATIENTS AND METHODS: We retrospectively reviewed data over a 5-year period for patients with solitary, renal and upper ureteric stones measuring <2 cm in whom ESWL was the treatment method. Group A consisted of 44 children (mean [SD] age 5.9 [4.4] years) and group B of 562 adults (mean [SD] age 40.9 [13.1] years). The number and energy of SWs used was not predetermined and was tailored until adequate fragmentation was achieved. Initial stone reassessment was performed at 48 h and monthly thereafter. The number of SWs, intensity of SWs, stone-free rate, auxiliary procedure rate, re-treatment rate, complication rate and effectiveness quotient (EQ) were assessed in each group.
RESULTS: The stone-free rate with ESWL was 84% in children and 87% in adults (P = 0.78). The EQ was 77% and 75% in children and adults, respectively (P = 0.56). The mean (sd) number of SWs and energy required per session was 950 (349) and 11.83 (0.48) kV in children and 1262 (454) and 12.36 (0.34) kV in adults (P < 0.001). The re-treatment, auxiliary procedure and complication rates were similar in both groups.
CONCLUSION: ESWL is as safe and effective in children as in adults for solitary renal and upper ureteric stones that are <2 cm. Children required significantly fewer and lower energy SWs to achieve equivalent results.

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Year:  2008        PMID: 18727616     DOI: 10.1111/j.1464-410X.2008.07887.x

Source DB:  PubMed          Journal:  BJU Int        ISSN: 1464-4096            Impact factor:   5.588


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