Schults AJ et al, 2017: Combination of Extracorporeal Shockwave Lithotripsy and Ureteroscopy for Large Staghorn Calculi in a Pediatric Patient: Case Report.
Schults AJ, Jia W, Ost MC, Oottamasathien S.
Division of Pediatric Urology, Department of Surgery, Primary Children's Hospital, University of Utah, Salt Lake City, Utah.
Division of Pediatric Urology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Schults AJ, Jia W, Ost MC, Oottamasathien S.
Division of Pediatric Urology, Department of Surgery, Primary Children's Hospital, University of Utah, Salt Lake City, Utah.
Division of Pediatric Urology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Abstract
Background: Extracorporeal shockwave lithotripsy (SWL) is a procedure commonly performed to treat nephrolithiasis, with promising results in pediatric patients. However, increasing renal calculi size is directly related to worsening stone-free rates. There are few reports in the literature of >2-cm staghorn calculi that expound on the exact mechanism of treatment in the pediatric population.
Case Presentation: We present a case report of a 3-year-old boy who presented with a large 3-cm staghorn calculi effectively treated with one session of SWL followed by a planned staged ureteroscopy for definitive treatment.
Conclusion: Despite the numerous studies limiting the use of SWL to treat stones
J Endourol Case Rep. 2017 May 1;3(1):64-66. doi: 10.1089/cren.2017.0029. eCollection 2017
Comments 1
A stone with staghorn configuration was treated with one SWL session followed by URS after two weeks. The result after ONE session of SWL was surprisingly good. Although it is difficult to judge the extent of stone clearance after one session from the published images, one can speculate whether it had been possible to solve the problem with only SWL, antibiotics and acidification?