Iqbal N et al, 2016: Stone-Free-Rate After Extracorporeal Shockwave Lithotripsy in the Management of Pediatric Renal Stones in Lower Pole and Other Locations - A Comparative Study.
Iqbal N, Muhammad S, Zafar W, Tashfeen R, Faiz J, Hasan A, Hussain I, Akhter S.
Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad.
Medical Student, Bahria University Medical and Dental College, Karachi.
Medical Student, Shifa College of Medicine, Shifa Tameer-e- Millat University, Islamabad.
Abstract
OBJECTIVE: To determine a difference in the stone-free-rate among different renal locations in children after extracorporeal shockwave lithotripsy (ESWL).
STUDY DESIGN: A descriptive study.
PLACE AND DURATION OF STUDY: Urology Department, Shifa International Hospital, Islamabad, Pakistan, from January 2007 to June 2015.
METHODOLOGY: The study included children who underwent ESWL, divided into three groups based on location of stones in kidney as group A (lower pole stones), group B (upper and mid pole stones) and group C (renal pelvis stone), respectively. ESWL was done by standard technique using Storz Modulith SLX lithotripter 3rd generation. Data was collected by chart review. SPSS version 16 was used for data analysis.
RESULTS: Among 76 children with mean age of 7.55 ±4.16 years, 55 (72.4%) were males whereas 21 (27.6%) were females. Mean stone size was 1.08 ±0.59 cm. There were 34, 17 and 25 cases in groups A, B and C, respectively. Post- ESWL stone-free-rate was 47% in lower pole stones, 70.58% in upper and mid pole stones, and 68% in renal pelvis stones. Hematuria was seen in one patient from each group, sepsis in two patients from each of the mid pole/upper pole and lower pole group, while Steinstrasse in one patient from each group.
CONCLUSION: ESWL is a safe and effective way of treating renal stones in all poles in pediatric population.
J Coll Physicians Surg Pak. 2016 Nov;26(11):908-911.
Comments 1
This article presents treatment results in paediatric patients treated with Storz Modulith SLX lithotripter.
The stone-free rates were as follows:
Although the authors conclude that SWL is safe and effective for stones in all locations of the kidney, it is obvious that lower calyx stones represent a problem. The results for lower calyx stones were most successful when the stones were smaller than 10 mm (stone-free rate 52%).
Usually young and mobile children would be expected to efficiently clear the lower calyx but obviously also in this age group is there need for better fragment elimination.