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Alsagheer G et al, 2017: Extracorporeal shock wave lithotripsy (ESWL) monotherapy in children: Predictors of successful outcome.

Alsagheer G, Abdel-Kader MS, Hasan AM, Mahmoud O, Mohamed O, Fathi A, Abass M, Abolyosr A.
Urology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt.

Abstract

INTRODUCTION AND OBJECTIVES: Although extracorporeal shock wave lithotripsy (ESWL) is the first choice for pediatric renal calculi PATIENTS AND METHODS: A prospective study including 100 children with renal stone burden RESULTS: Between January 2013 and October 2015, 100 children were treated with a Dornier Gemini lithotripter at the present institution. The mean patients age and stone size were 6 years (range: 1.8-14) and 13.1 mm (range: 6-20), respectively. After one session, 47% of patients showed complete clearance 3 months postoperative, those patients versus those who required an additional session or auxiliary procedures were younger in age, with smaller stone size and lower density. On multivariate analysis, only patient age was an independent predictor of success (odds ratio (OR) 0.9; P < 0.001).
CONCLUSION: Patient's age was an important predictor for response after ESWL monotherapy: not only did children respond better than adults, but age was also an independent predictor within the pediatric group.

J Pediatr Urol. 2017 Apr 18. pii: S1477-5131(17)30171-7. doi: 10.1016/j.jpurol.2017.03.029. [Epub ahead of print]

 

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Comments 1

Hans-Göran Tiselius on Wednesday, 04 October 2017 09:55

Based on the reported poor outcome of ESWL in children, with SFR of only 47% after one treatment, the authors analysed the predictors of success in 100 patients. It is of note that the best results were recorded in children 4 mm (as observed after one month). Possibly this was an over-treatment of some children with residuals of borderline size, in view of the well recognized great capacity of the child’s ureter to eliminate also large fragments.

Based on the reported poor outcome of ESWL in children, with SFR of only 47% after one treatment, the authors analysed the predictors of success in 100 patients. It is of note that the best results were recorded in children 4 mm (as observed after one month). Possibly this was an over-treatment of some children with residuals of borderline size, in view of the well recognized great capacity of the child’s ureter to eliminate also large fragments.
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