Extracorporeal shock wave lithotripsy for urinary tract stones in pediatric patients: our 11 years of experience

Abstract

Purpose To reveal the efficacy of ESWL in pediatric patients and determine factors that will increase the success rate of this procedure. Materials and Methods The files of patients aged 16 years and under who underwent ESWL at our clinic between January 2010 and December 2021 were retrospectively reviewed. Age, gender, stone area, stone localization, number of sessions, energy and frequency used, complete stone-free status, and secondary intervention requirement were recorded. The absence of stone fragments or the presence of fragments smaller than 3 mm in imaging after ESWL was considered as success. Results This study included 433 pediatric patients. The mean age of the patients was calculated as 12.02 ± 4.67 (range, 1–16) years. The most important factors affecting the number of residual stones were stone localization (p = 0.045) and size (p < 0.0001). When stone localization was compared according to patient age, the patients with a higher age were found to have a significantly higher rate of stones in the proximal ureter than in the lower calyx of the kidney (p = 0.045) and renal pelvis (p = 0.048). Conclusion Based on our 11-year pediatric ESWL experience in our clinic, our stone-free rate increased compared to the first years we started to perform this procedure. Despite advances in laser breaker technology and micro and ultra-thin endoscopic instruments developed for stone intervention, ESWL can still be safely performed as the first choice in stones smaller than 20 mm.