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Extracorporeal Shock Wave Lithotripsy for Renal Calculi

2009; Lippincott Williams & Wilkins; Volume: 182; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2009.03.018

1527-3792

Heidi A. Penn, Romano T. DeMarco, Ashley Sherman, John M. Gatti, J. Patrick Murphy,

Porphyrin Metabolism and Disorders

No AccessJournal of UrologySection on Urology American Academy of Pediatrics1 Oct 2009Extracorporeal Shock Wave Lithotripsy for Renal Calculi Heidi A. Penn, Romano T. DeMarco, Ashley K. Sherman, John M. Gatti, and J. Patrick Murphy Heidi A. PennHeidi A. Penn More articles by this author , Romano T. DeMarcoRomano T. DeMarco More articles by this author , Ashley K. ShermanAshley K. Sherman More articles by this author , John M. GattiJohn M. Gatti More articles by this author , and J. Patrick MurphyJ. Patrick Murphy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2009.03.018AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To gain better understanding of ESWL® efficacy in children with renal calculi we report our outcomes using this technique. Materials and Methods: We reviewed the records of children who underwent ESWL as monotherapy for renal calculi at our institution from 1988 to 2007. Data included clinical characteristics, stone-free rate and its relationship to stone size and location, lithotriptor and complications. Results: The 33 boys and 29 girls with an average age of 10 years underwent a total of 69 treatments. A 53% and 63% stone-free rate was achieved after 1 and 2 ESWL sessions, respectively. A trend toward a higher stone-free rate (61% to 70%) after 1 ESWL session was seen in children with stones less than 50 mm2, renal pelvic stones and treatment with the Dornier® HM3 lithotriptor. Children with stones greater than 100 mm2, a caliceal location and those treated with the Dornier MFL 5000 lithotriptor had a higher failure rate (25% to 46%). Five patients (8%) required ureteroscopy after ESWL due to retained distal ureteral stone fragments. Five patients (8%) who were not stone-free after therapy required subsequent endoscopic treatment for the stone during followup. Conclusions: Smaller renal stones, renal pelvic calculi and treatment with an older generation lithotriptor were independent variables associated with a higher stone-free rate in children. While ESWL is a simple method in children with renal calculi, those with large or caliceal stones may do best with a primary endoscopic approach. References 1 : Extracorporeal lithotripsy in the treatment of renal lithiasis: 5 years' experience. J Urol (Paris)1986; 92: 339. Google Scholar 2 : Extracorporeal shock wave lithotripsy in children. J Urol1986; 136: 238. Link, Google Scholar 3 : The effects of extracorporeal shock wave lithotripsy on renal growth, function and arterial blood pressure in an animal model. J Urol1991; 146: 544. Link, Google Scholar 4 : Initial experience with extracorporeal shock wave lithotripsy in children. J Urol1987; 138: 839. Link, Google Scholar 5 : Is ureterscopy first line therapy for pediatric stone disease?. J Urol2007; 178: 2128. Link, Google Scholar 6 : Safety and efficacy of percutaneous nephrolithotomy in the pediatric population. J Endourol2008; 22: 637. Google Scholar 7 : Extracorporeal shock wave lithotripsy in children. Eur Urol2001; 39: 591. Google Scholar 8 : Extracorporeal shock wave lithotripsy in the management of pediatric urolithiasis. Urol Res2006; 34: 315. Google Scholar 9 : Extracorporeal shock wave lithotripsy in children. World J Urol2004; 22: 115. Google Scholar 10 : Monotherapy extracorporeal shock wave lithotripsy for the treatment of staghorn calculi in children. J Urol2001; 165: 2324. Link, Google Scholar 11 : Outcome of small residual stone fragments following shock wave lithotripsy in children. J Urol2004; 172: 1600. Link, Google Scholar 12 : Efficacy of extracorporeal shock wave lithotripsy for isolated lower caliceal stones in children compared with stones in other renal locations. Urology2006; 67: 170. Google Scholar 13 : Extracorporeal shock wave lithotripsy in children: experience using two second-generation lithotripters. BJU Int2000; 86: 851. Google Scholar 14 : The impact of radiological anatomy in clearance of lower calyceal stones after shock wave lithotripsy in paediatric patients. Eur Urol2003; 43: 188. Google Scholar 15 : Lower caliceal stone clearance after shock wave lithotripsy or ureteroscopy: the impact of lower pole radiographic anatomy. J Urol1998; 159: 676. Link, Google Scholar 16 : The impact of radiological anatomy in clearance of lower calyceal stones after shock wave lithotripsy in paediatric patients. Eur Urol2003; 43: 188. Google Scholar 17 : A prospective trial comparing the efficacy and complications of the modified Dornier HM3 and MFL 5000 lithotriptors for solitary renal calculi. J Urol1995; 153: 1794. Link, Google Scholar 18 : Outcomes using a fourth-generation lithotripter: a new benchmark for comparison. BJU Int2007; 100: 1356. Google Scholar 19 : Ureteroscopy is safe and effective in prepubertal children. J Urol2005; 174: 276. Link, Google Scholar Division of Pediatric Urology and Medical Research-Biostatistics, Children's Mercy Hospital, Kansas City, Missouri© 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byTuncer M, Sahin C, Yazici O, Kafkasli A, Turk A, Erdogan B, Faydaci G and Sarica K (2018) Does Extracorporeal Shock Wave Lithotripsy Cause Hearing Impairment in Children?Journal of Urology, VOL. 193, NO. 3, (970-974), Online publication date: 1-Mar-2015. Volume 182Issue 4SOctober 2009Page: 1824-1828 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordskidney calculilithotripsykidneyendoscopyMetricsAuthor Information Heidi A. Penn More articles by this author Romano T. DeMarco More articles by this author Ashley K. Sherman More articles by this author John M. Gatti More articles by this author J. Patrick Murphy More articles by this author Expand All Advertisement PDF downloadLoading ...