Greater and lesser ischiadic foramina as path of shock wave lithotripsy for distal ureteral stone in children.
OBJECTIVE
We evaluated the efficacy and safety of shock wave lithotripsy in the supine position through the greater and lesser ischiadic foramina as a path of shock wave to treat distal ureteral stones in young children.


METHODS
We treated 22 young children with distal urinary calculi using the Dornier Compact S lithotriptor between 1997 and 2007. The study population consisted of 15 boys and 7 girls 6 months to 7 years old (mean +/- SD 5.4 +/- 2.1 years). Stone size ranged from 5 to 16 mm (mean 6.8). All patients were treated in the supine position under dissociative anesthesia with ketamine. The focused shock wave targeted the stone in the distal ureter through the greater and lesser ischiadic foramina.


RESULTS
Number of shocks ranged from 600 to 3,000 (mean +/- SD 2,346.2 +/- 483.7). Energy per pulse ranged from level 4 to 5 (mean 4.5). Treatment time varied from 20 to 40 minutes (mean 31). Stone-free rate at 2 weeks after lithotripsy was 77.3%, which increased to 100% at 3 months after a single lithotripsy session. No serious side effects were observed.


CONCLUSIONS
Shock wave lithotripsy in the supine position through the greater and lesser ischiadic foramina as the path of shock wave treats distal ureteral stones in young children with an excellent success rate and few side effects.
Sun
Xizhao
X
Department of Urology and Pharmacy, Drum Tower Hospital, Nanjing University, Nanjing, China. lygheleij@163.com
He
Lei
L
Lu
Jianlin
J
Cong
Xiaoming
X
Shen
Luming
L
Wang
Ying
Y
Zhu
Huaijun
H
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007512:Ischium; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D056888:Patient Positioning; D016683:Supine Position; D014514:Ureteral Calculi / Q000473:pathology / Q000628:therapy*