Extracorporeal shock wave lithotripsy in prepubertal children: 22-Year experience at a single institution with a single lithotriptor

Ezekiel H. Landau, Ofer Z. Shenfeld, Dov Pode, Amos Shapiro, Shimon Meretyk, Giora Katz, Ran Katz, Mordechai Duvdevani, Benjamin Hardak, Helio Cipele, Guy Hidas, Vladimir Yutkin, Ofer N. Gofrit

Research output: Contribution to journalArticlepeer-review

64 Scopus citations

Abstract

Purpose: The sophistication of percutaneous nephrolithotomy and ureteroscopy challenges the efficacy of ESWL® for urolithiasis in prepubertal patients. We evaluated our long-term experience with ESWL in these patients and determined its efficiency. Materials and Methods: We retrospectively reviewed the charts of all prepubertal patients who underwent ESWL. We evaluated the need for tubing, the 3-month stone-free rate, the need for additional ESWL, and the effect of stone size and location, and cystinuria on the 3-month stone-free rate. Results: Between 1986 and 2008, 119 males and 97 females with a mean age of 6.6 years who had urolithiasis underwent ESWL using the Dornier® HM3 lithotriptor. We treated 157 children with renal calculi with an average ± SD diameter of 14.9 ± 8.9 mm, of whom 66 (42%) required a tube in the urinary system. The 3-month stone-free rate was 80% and 31 patients (19.7%) needed an additional procedure. Stone location did not affect the stone-free rate but stone size did.We treated 59 patients for ureteral stones with an average stone length of 9.5 ±4.8 mm, of whom 41 (69%) required tube insertion. The 3-month stone-free rate was 78% and 13 patients (22%) needed an additional procedure. The 3-month stone-free rate did not depend on stone location or size. The rate was 37.5% in patients with cystinuria and 82.5% in all others (p <0.0001). Six patients (2.8%) had complications. Conclusions: The 3-month stone-free rate after ESWL in prepubertal patients is 80% and 20% of patients require additional procedures. ESWL is most effective for kidney stones less than 11 mm. ESWL has inferior results for cystine stones compared to other calculi. Complications are rare.

Original languageEnglish
Pages (from-to)1835-1840
Number of pages6
JournalJournal of Urology
Volume182
Issue number4 SUPPL.
DOIs
StatePublished - Oct 2009
Externally publishedYes

Keywords

  • Calculi
  • Cystine
  • Kidney
  • Lithotripsy
  • Ureter

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