title: Are there long-term effects of extracorporeal shockwave lithotripsy in paediatric patients?
abstract: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Extracorporeal shockwave lithotripsy is effective for the treatment of paediatric renal stones with favourable short-term safety. Extracorporeal shockwave lithotripsy for treatment of paediatric renal stones is also safe for the kidney and the child on long-term follow-up.
  
  
  OBJECTIVE
  To evaluate the long-term effects of extracoporeal shockwave lithotripsy (SWL) for treatment of renal stones in paediatric patients.
  
  
  METHODS
  A database of paediatric patients who underwent SWL monotherapy for treatment of renal stones from September 1990 through to January 2009 was compiled. This study included only patients with follow-up for more than 2 years. The long-term effects of SWL were evaluated at the last follow-up with measurement of patients' arterial blood pressure, estimation of random blood sugar and urine analysis. The results of diastolic blood pressure were plotted against a standardized age reference curve. The treated kidney was examined by ultrasonography for measurement of renal length and detection of stones. The measured renal lengths were plotted against age-calculated normal renal lengths in healthy individuals.
  
  
  RESULTS
  The study included 70 patients (44 boys (63%) and 26 girls) with mean age at the time of SWL 6.5 ± 3.6 years (range 1-14). The mean follow-up period was 5.2 ± 3.6 years (range 2.1-17.5). The mean age at last follow-up was 11.7 ± 5.3 years (range 4.4-27.5). No patients developed hypertension or diabetes. Only one treated kidney was smaller than one standard deviation of the calculated length. The cause of this was obstruction by a stone in the pelvic ureter 3 years after SWL.
  
  
  CONCLUSIONS
  The long-term follow-up after SWL for treatment of renal stones in paediatric patients showed no effect on renal growth and no development of hypertension or diabetes.
authors.affiliation: Urology Department, Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt. ar_el_nahas@yahoo.com
authors.forename: Ahmed R
authors.initials: AR
authors.lastname: El-Nahas
authors.forename: Bassam A
authors.initials: BA
authors.lastname: Awad
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: El-Assmy
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abou El-Ghar
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Eraky
authors.forename: Mahmoud R
authors.initials: MR
authors.lastname: El-Kenawy
authors.forename: Khaled Z
authors.initials: KZ
authors.lastname: Sheir
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013995:Time; D016896:Treatment Outcome; D014463:Ultrasonography