title: Efficacy of extracorporeal shock wave lithotripsy for ureteric stones in children.
abstract: OBJECTIVE
  Management of ureteral stones in children represents a challenging problem. In this study, we retrospectively analyzed our experience with extracorporeal shock wave lithotripsy (ESWL) in 192 children with ureteric stones.
  
  
  METHODS
  Between 1990 and 2003, 192 children (<or= 14 years old) with ureteric calculi were treated with the Siemens Lithostar Plus (Siemens Medical Systems, Iselin, NJ). There were 39 stones in the proximal ureter, 19 in the mid-ureter and 134 in the distal ureter.
  
  
  RESULTS
  Mean patient age was 7.3+/-4.1 years (6 months-14 years). There were 122 boys (64.2%) and 70 girls (35.8%). All procedures were performed on an outpatient basis with intravenous sedation in 73 cases (38.1%), general anesthesia in 68 cases (35.7%) and no anesthesia in 51 cases (26.2%). A maximum of 3500 shocks and 18 kV per session were used. A 94% success rate was achieved in proximal (n: 39) and mid-ureteral stones (n: 19). Stone free rates for distal ureteral calculi were 90.6% for stones less than 1 cm in diameter (n: 94) and 91.7% for stones between 1 and 2 cm (n: 26). Overall re-treatment and efficacy quotient rates for proximal ureteral stones were 45.1% and 68.9%, 62.5% and 61.5% for mid-ureteral calculi, and 49.6% and 60.0% for distal ureteral stones.
  
  
  CONCLUSIONS
  Our results indicate that ESWL with highly satisfactory stone free rates ranging between 90 and 100% and negligible complications can be considered as a first line treatment for ureteric stones in the pediatric age group.
authors.affiliation: Department of Urology, Haseki Teaching and Research Hospital, 34096-Haseki, Istanbul, Turkey.
authors.forename: Ahmet Yaser
authors.initials: AY
authors.lastname: Muslumanoglu
authors.forename: Ahmet Hamdi
authors.initials: AH
authors.lastname: Tefekli
authors.forename: Fatih
authors.initials: F
authors.lastname: Altunrende
authors.forename: Mert Ali
authors.initials: MA
authors.lastname: Karadag
authors.forename: Murat
authors.initials: M
authors.lastname: Baykal
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Akcay
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D010045:Outpatients; D012189:Retrospective Studies; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000628:therapy*