Introduction and Objectives
To evaluate success of shock wave lithotripsy (SWL) with a third generation SWL machine and to determine the relation between stone burden and the degree of hydronephrosis in children with urinary stones.
Material and Methods
Two hundred and sixty children with urinary system stones were treated with Siemens Lithostar Modularis Uro-Plus. The patients were divided into three groups according to stone burden (group 1: <100 mm2; group 2: 101– 200 mm2; and group 3: >200 mm2) and four groups (group 0: absent; group 1: mild; group 2: moderate; and group 3: severe) according to the degree of hydronephrosis. These groups were compared in terms of the success rate of SWL.
Two hundred and seventy-nine renoureteral units of 260 patients were treated at 402 SWL sessions. In all patients the average stone burden was 98.2 mm2 (range, 11–525). The overall success rate was 87.5%. According to stone burden, the success rate was 93.1% in group 1, 85.5% in group 2 and 60% in group 3 (p < 0.001). According to the degree of hydronephrosis, the success rate was 93.8% in group 0, 89.6% in group 1, 73.3% in group 2, and 64.3% in group 3 (p < 0.001). The average energy, number of shockwaves, number of sessions, re-treatment rate, auxiliary procedure rate, and overall efficacy quotient were 1.76 units, 2260, 1.4, 33%, 8.2%, and 0.62 respectively.
SWL is an effective treatment method in selected patient groups in pediatric age. However, percutaneous nephrolithotomy can be the first alternative for stones larger than 200 mm2. It should also be kept in mind that the success rate of SWL decreases when the degree of hydronephrosis increases.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.