MONOTHERAPY EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY FOR THE TREATMENT OF STAGHORN CALCULI IN CHILDREN
- 1 June 2001
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 165 (6 Part 2), 2324-2327
- https://doi.org/10.1016/s0022-5347(05)66195-2
Abstract
We evaluate the efficacy and parenchymal consequences of extracorporeal shock wave lithotripsy (ESWL * ) for staghorn calculi in children. From 1991 to 1999, 16 young patients 5.5 months to 2 years old and 7 older children 6 to 11 years old were treated for complete (6) or partial (17) staghorn calculi. Infection was the main factor of lithogenesis, particularly in younger children. In 21 patients the stone burden was more than 20 mm. All patients were treated under general anesthesia using a 14 kV. Sonolith 3000 † (14) or a 12 to 20 kV. Nova ‡ (9) lithotriptor. In 5 of the 7 older children a Double J § stent was inserted before treatment. In the younger children group calculi were fragmented after 1 (11) or 2 (5) sessions. Of the 7 older children 3 required 3 (1) and 4 (2) treatment sessions. To assess the long-term effect of ESWL on the parenchyma, dimercapto-succinic acid renal scan was performed the day before and 6 months after therapy in 20 patients. Of the 16 younger children 14 became stone-free (87.5%) and 2 had small asymptomatic residual fragments. Of the 7 older children 5 were stone-free (71.4%) and 2 required additional surgery. No steinstrasse or pyelonephritis occurred after ESWL and no parenchymal or ureteral lesion related to ESWL was identified on conventional dimercapto-succinic acid scintigraphy. At a followup of 9 months to 9 years all patients have normal blood pressure. ESWL as a first option is safe and appropriate for the treatment of staghorn calculi in children particularly in younger children with infected calculi.Keywords
This publication has 20 references indexed in Scilit:
- Paediatric anatrophic nephrolithotomy; stone clearance — at what price?BJU International, 2000
- PERCUTANEOUS NEPHROLITHOTOMY IN THE PEDIATRIC POPULATIONJournal of Urology, 1999
- Pediatric Percutaneous Nephrolithotomy: Assessing Impact of Technical Innovations on Safety and EfficacyJournal of Endourology, 1999
- The Role of Percutaneous Nephrolithotomy in the Management of Pediatric Renal CalculiJournal of Urology, 1997
- Complete Staghorn Calculi: Random Prospective Comparison Between Extracorporeal Shock Wave Lithotripsy Monotherapy and Combined With Percutaneous NephrostolithotomyJournal of Urology, 1997
- Open stone surgery: Is it still a preferable procedure in the management of staghorn calculi?International Urology and Nephrology, 1994
- Infection stones in children: A twenty-seven-year reviewUrology, 1994
- Clinical Patterns of Paediatric UrolithiasisBJU International, 1991
- Extracorporeal Shockwave Lithotripsy Monotherapy for Paediatric Urinary Tract CalculiBJU International, 1990
- Extracorporeal Shockwave Lithotripsy Monotherapy for Large Renal CalculiBJU International, 1989