Extracorporeal shock wave lithotripsy in children: Results and short-term complications.
OBJECTIVE
The introduction of extracorporeal shock wave lithotripsy represented an important evolution in urinary tract lithiasis management. The aim of this study is to describe the results of extracorporeal shock wave lithotripsy for the treatment of urinary tract lithiasis in children, focusing on the index of elimination of the calculi and the complications occurring during the procedure and during the following three months.


METHODS
From September 1991 to July 2002, 135 children between one and 12 years, suffering from urinary tract lithiasis underwent extracorporeal shock wave lithotripsy. A retrospective analysis of these patients was carried out.


RESULTS
One hundred and ninety-five calculi ranging in size from 5.0 mm to 20.0 mm were treated, out of which 147 were found in the kidneys and 48 in the ureter. Urinary tract dilation was presented by 30% of the children at the time of the procedure. After extracorporeal shock wave lithotripsy 75.8% of the calculi were eliminated: 64.1% were stone-free and 11.7% had < or = 4 mm stones. Ureteral calculi and 5-10 mm stones responded better than the kidney and 11-20 mm stones (P = 0.027 and P = 0.012, respectively). No differences were detected according to the calculi location, whether in the ureter or kidney (P = 0.637 and P = 0.703, respectively). The shock wave intensity of 14kv was as efficient as the higher voltage. Short-term complications were observed in 23.7%, characterized by fever and pain.


CONCLUSIONS
In children, extracorporeal shock wave lithotripsy proved to be able to eliminate 75.8% of the treated calculi and 83.7% of the patients presented a complete or partial response. Complications were observed in 23.7% of patients, and pain was the most frequent symptom.
Lithocenter (center for treatment of renal calculi at Hospital Nossa Senhora de Lourdes, in São Paulo - Brazil), São Paulo, Brazil.
João Paulo
JP
da Cunha Lima
Ricardo Jordão
RJ
Duarte
Lílian Maria
LM
Cristofani
Miguel
M
Srougi
D002648:Child; D002675:Child, Preschool; D005260:Female; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D007223:Infant; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D052878:Urolithiasis / Q000628:therapy*; D018879:Ventricular Premature Complexes / Q000209:etiology*