title: Comparison of Extracorporeal Shock Wave Lithotripsy for Urolithiasis Between Children and Adults: A Single Centre Study.
abstract: OBJECTIVE
  To retrospectively evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) for urolithiasis and compare the results between children and adults.
  
  
  METHODS
  From January 2011 to January 2015 (four years), ESWL was performed in 104 children and 300 adults for urolithiasis. MODULITH®SLX-F2 lithotripter (Storz Medical AG, Tägerwilen, Switzerland) equipment was used for ESWL. The stone-free rates, the number of ESWL sessions required, complication rates and ancillary procedures used were evaluated in a comparative manner.
  
  
  RESULTS
  The mean age ± standard deviation (SD) of children was 7.84±4.22 years and of adults was a 40.22±1.57 years. Mean ± SD of the stone size was 1.28±61 cm in the adults while 1.08 ± 0.59 cm in the children. In adults, the complications included steinstrasse in six (1.98%) patients, fever in 15 (4.95%), hematuria in 19 (6.28%) and sepsis in six (1.98%) patients. In children, steinstrasse was observed in two (1.9%), mild fever in two (1.9%), hematuria in six (5.7%) and sepsis was seen in four (3.8%) patients. The overall complication rate in the adults and in the children, it was found to be 46/300 (15%) and in the children, it was seen to be 14/104 (13%). No statistical difference was found in post-ESWL complications between children and adults (P>0.05). Ancillary procedures including double J (DJ) stent were used in 13 (12.5%) children and 87 (29%) adults. There was a better stone clearance rate in children i.e. 79% as compared to 68% in adults (X2:P=0.036).
  
  
  CONCLUSIONS
  Children can achieve high stone-free rates after ESWL with a lower need for repeat ancillary procedures as compared to adults. However, there is a difference in the post-ESWL complications between these groups.
authors: `Department of Urology, Shifa International Hospital, Islamabad, Pakistan.
authors: Nadeem
authors: N
authors: Iqbal
authors: Department of Neurology & Neurosurgery, Shifa Tameer-e-Millat University, Islamabad, Pakistan.
authors: Salman
authors: S
authors: Assad
authors: Department of Urology, Shifa International Hospital, Islamabad, Pakistan.
authors: Joshua
authors: J
authors: Rahat Aleman Bhatti
authors: Department of Urology, Shifa International Hospital, Islamabad, Pakistan.
authors: Aisha
authors: A
authors: Hasan
authors: Department of Cardiology, Shifa International Hospital, Islamabad, Pakistan.
authors: Muhammad Usman
authors: MU
authors: Shabbir
authors: Department of Urology, Shifa International Hospital, Islamabad, Pakistan.
authors: Saeed
authors: S
authors: Akhter
keywords: adults; complication; eswl; pediatric; stone free rate