Extracorporeal shock wave lithotripsy in children.
OBJECTIVE
We analyzed the efficacy of extracorporeal shock wave lithotripsy in children.


METHODS
Between 1987 and 2000, 15,423 patients with urinary calculi were treated at our institution, of whom 86 (0.56%) children 3 to 14 years old underwent lithotripsy using the Siemens Lithostar Plus (Siemens Medical Systems, Iselin, New Jersey). A total of 121 calculi in 90 urinary tracts were treated requiring 149 extracorporeal shock wave lithotripsy sessions. The stones were caliceal in 62 cases, renal pelvic in 35, ureteral in 18 and staghorn in 6. Followup consisted of nephrotomogram or ultrasound 1 day and 1 to 3 months postoperatively.


RESULTS
Complete removal of all stone fragments was achieved in 97.6% of the stones after 3 months. Re-treatment was necessary in 24 patients (27.9%). All patients were treated as outpatients with intravenous sedation in 54 (62.8%), general anesthesia in 13 (15.1%) and no anesthesia in 19 (22.1%). Complications were present in 8 patients (10.7%) who had colic and received medical treatment followed by uneventful recovery.


CONCLUSIONS
Extracorporeal shock wave lithotripsy using the Lithostar Plus has been demonstrated to be an effective noninvasive procedure to treat radiopaque and even radiolucent or slightly opaque urinary calculi in children.
Rodrigues Netto
Nelson
N
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Longo
José Antonio
JA
Ikonomidis
Jean A
JA
Rodrigues Netto
Mauricio
M
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy; D008297:Male; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*