Speed of stone clearance after shock wave lithotripsy in pediatric urolithiasis
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Author(s)
Speed of stone clearance after shock wave lithotripsy in pediatric urolithiasis Arthur Grabsky
The aim of this study is to summarize the first 10 years of experience of extracorporeal shock wave lithotripsy in pediatric patients with urolithiasis.
Single-center, whole-country, retrospective comparative study using data from cohort of pediatric urolithiasis patients who underwent shock wave lithotripsy between 2005 and 2014.
A total of 125 pediatric patients (male/female: 67/58, mean age: 10.22 years, range: 1–18) underwent 142 shock wave sessions in Armenia within the 10-year period, including 104 with primary and 21 with recurrent urolithiasis. In total, 164 stones were detected, involving 96 (58.5%) in boys and 68 (41.5%) in girls. Low-energy shockwaves with a frequency of 1-2 were used to achieve stone fragmentation in most patients. One session comprised of 200 to 3,000 shockwave impulses, required for sufficient stone fragmentation, although some patients required more than 8,000 impulses during four subsequent sessions. All but one (99.2%) cases reported successful stone clearance at 3-month follow-up. In this study were identified, that the younger age was associated with faster stone clearance, which probably was due to the shorter urinary tracts and thinner “barrier” between the device and the stone. Also, children who reported renal
colic before lithotripsy had a significantly lower chance to get rid of stones within 2 days than those who did not. This can be explained by the underlying mechanism of the colic, which develops against the background of the spasm of ureteric walls. No significant obstructive, infectious, or other serious complications were observed. Mild macrohematuria during the first post-lithotripsy days and “steinstrasse” were reported practically in all patients, as expected during the postoperative course.
Extracorporeal shock wave lithotripsy proved to be a safe and highly effective minimally invasive treatment of children with kidney stone disease.
DOI: https://ysmu.am/v2/wp-content/uploads/2023/05/f7628272-1.pdf The New Armenian Medical Journal Vol.14 (2020), Nо 3 73-79
