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Iqbal N et al, 2016: Comparison of Extracorporeal Shock Wave Lithotripsy for Urolithiasis Between Children and Adults: A Single Centre Study.

Iqbal N, Assad S, Rahat Aleman Bhatti J, Hasan A, Shabbir MU, Akhter S.
Department of Neurology & Neurosurgery, Shifa Tameer-e-Millat University, Islamabad, Pakistan.
Department of Urology, Shifa International Hospital, Islamabad, Pakistan.
Department of Cardiology, Shifa International Hospital, Islamabad, Pakistan.

Abstract 

OBJECTIVE: To retrospectively evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) for urolithiasis and compare the results between children and adults.
MATERIALS AND 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) .
CONCLUSION: 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. 

Cureus. 2016 Sep 29;8(9):e810.

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Comments 1

Peter Alken on Wednesday, 10 May 2017 09:12

Good results but SFR was determined by KUB and/or sonography only and the complications were not classified. I always wonder why hematuria requiring no therapeutic intervention is regarded as a complication of ESWL.

Good results but SFR was determined by KUB and/or sonography only and the complications were not classified. I always wonder why hematuria requiring no therapeutic intervention is regarded as a complication of ESWL.
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