Jeong US et al, 2013: Factors affecting the outcome of extracorporeal shock wave lithotripsy for unilateral urinary stones in children: a 17-year single-institute experience
Jeong US, Lee S, Kang J, Han DH, Park KH, Baek M
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
PURPOSE: Extracorporeal shock wave lithotripsy (ESWL) is a first-line treatment for pediatric urinary stone disease. We aimed to determine the factors affecting the outcome of ESWL for unilateral urinary stones in children.
MATERIALS AND METHODS: A total of 81 pediatric patients aged 0 to 16 years with urinary stones treated by ESWL from January 1995 through May 2012 were retrospectively reviewed. All patients were required to have unilateral urinary stone disease. Children who underwent other surgical procedures before ESWL were excluded. Outcomes evaluated after ESWL were the stone-free rate at 3 months after ESWL, success within a single session, and success within three sessions. Factors affecting the success within three sessions were also analyzed.
RESULTS: The final analysis was for 42 boys and 22 girls (mean age, 9.2±5.2 years). Of these 64 patients, 58 (90.6%) were treated by ESWL without other surgical procedures and 54 (84.4%) were successfully treated within three ESWL sessions. In the multivariate analysis, multiplicity (odds ratio [OR], 0.080; 95% confidence interval [CI], 0.012 to 0.534; p=0.009) and large stone size (>10 mm; OR, 0.112; 95% CI, 0.018 to 0.707; p=0.020) were significant factors that decreased the success rate within three ESWL sessions.
CONCLUSIONS: Most of the pediatric urinary stone patients in our study (90.6%) were successfully treated by ESWL alone without additional procedures. If a child has a large urinary stone (>10 mm) or multiplicity, clinicians should consider that several ESWL sessions might be needed for successful stone fragmentation.
Korean J Urol. 2013 Jul;54(7):460-6. doi: 10.4111/kju.2013.54.7.460. Epub 2013 Jul 15
PMID:23878689 [PubMed] PMCID:PMC3715710. FREE ARTICLE
I like this publication despite the naturally small numbers and recommend it to those treating children with stones.
There are detailed informations on the success rates of stones in different locations within the ureter and kidney. They can be used to council parents on what can be expected with a SWL treatment.