Extracorporeal shock wave lithotripsy in infants less than 12-month old

Abstract

There is a lack of literature on children compared to adults regarding the long-term effects of extracorporeal shock wave lithotripsy (SWL), specifically in infants. The aim of the present study was to analyze the efficacy and safety of SWL in infants and also evaluate its potential adverse effects in the mid-term. Between May 1999 and December 2013, 36 infants with 39 renal units underwent SWL treatment for kidney stones with an electrohydraulic lithotripter (Dornier MPL 9000/ELMED Multimed Classic). All children were less than 12-month old. The mid-term effects of SWL were examined at the last follow-up by measuring arterial blood pressure, random blood glucose level and ipsilateral kidney size. Evaluation of treatment and its consequences was based on clinical examination, blood tests and conventional imaging (plain abdominal radiography and ultrasound). Overall stone-free rate was 84.6 % after 3-month follow-up without any major complications. Mid-term follow-up was available in 20 of 36 children with a mean follow-up of 3.2 ± 2.8 years (range 0.5-15.3). None of the infants were found to develop new onset of hypertension or diabetes. All treated infant kidneys' sizes were in the normal percentile range. SWL for management of infant kidney stones is effective and safe in the mid-term.

Factors affecting the success of pediatric extracorporeal shock wave lithotripsy therapy: 26-year experience at a single institution

“…In the literature, it is stated that the child's age is not a limiting factor for ESWL and that even infants can be treated easily. 10 In the present study, both univariate and multivariate analyses showed that the mean age of the children in the stone-free group was lower. Better success in these children may be due to decreased stone burden, softer stone composition, better ureteral compliance, and less distance between the shock wave generator and the stone.…”

Outcomes of miniaturized percutaneous nephrolitotomy in infants: single centre experience

“…Limited reports about ESWL in infancy exist because of the rarity of renal stones in infancy. The success rate of ESWL in infant patient was 84.6-100% ( 11 , 12 ). Despite these high stone free rate of the procedure, ESWL has some disadvantages such as requirement of anesthesia, ureteral obstruction in high volume renal stones and higher additional intervention rate ( 13 ).…”

Outcomes of miniaturized percutaneous nephrolitotomy in infants: Single centre experience

“…Limited reports about ESWL in infancy exist because of the rarity of renal stones in infancy. The success rate of ESWL in infant patient was 84.6-100% (11,12). Despite these high stone free rate of the procedure, ESWL has some disadvantages such as requirement of anesthesia, ureteral obstruction in high volume renal stones and higher additional intervention rate (13).…”

“…Despite these high stone free rate of the procedure, ESWL has some disadvantages such as requirement of anesthesia, ureteral obstruction in high volume renal stones and higher additional intervention rate (13). In current literature ESWL is a safe method of treatment from the point of view of development of new onset diabetes mellitus and hypertension; however, long term detrimental effect of ESWL on kidney which can cause diabetes mellitus and hypertension is still controversial (12,14).…”