Staghorn Calculi in Children

Orsola, Anna; Díaz, Ignacio Morales; Caffaratti, Jorge; Izquierdo, Francisco Miguel; Alberola, J.; Garat, J.M.

doi:10.1097/00005392-199909000-00104

Cited by 10 publications

(5 citation statements)

References 17 publications

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“…[2] Our group recently reviewed results of 149 pediatric patients treated with a single session of ESWL at multiple community and academic centers in the Midwestern US and found a 71% stone-free rate. [6] In other pediatric series, ESWL has been demonstrated to be successful in treating large stones (20-30 mm), with a 95% stone-free rate,[7] staghorn calculi with a 73% stone-free rate[8] and lower-pole calculi with a stone-free rate between 61% and 92%. [79] Thus, the efficacy of ESWL for renal stones in the pediatric population is well established.…”

Section: Introductionmentioning

confidence: 99%

Pediatric extracorporeal shock wave lithotripsy: Predicting successful outcomes

McAdams

Shukla

2010

Indian J Urol

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Extracorporeal shock wave lithotripsy (ESWL) is currently a first-line procedure of most upper urinary tract stones <2 cm of size because of established success rates, its minimal invasiveness and long-term safety with minimal complications. Given that alternative surgical and endourological options exist for the management of stone disease and that ESWL failure often results in the need for repeat ESWL or secondary procedures, it is highly desirable to identify variables predicting successful outcomes of ESWL in the pediatric population. Despite numerous reports and growing experience, few prospective studies and guidelines for pediatric ESWL have been completed. Variation in the methods by which study parameters are measured and reported can make it difficult to compare individual studies or make definitive recommendations. There is ongoing work and a need for continuing improvement of imaging protocols in children with renal colic, with a current focus on minimizing exposure to ionizing radiation, perhaps utilizing advancements in ultrasound and magnetic resonance imaging. This report provides a review of the current literature evaluating the patient attributes and stone factors that may be predictive of successful ESWL outcomes along with reviewing the role of pre-operative imaging and considerations for patient safety.

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Section: Introductionmentioning

confidence: 99%

Pediatric extracorporeal shock wave lithotripsy: Predicting successful outcomes

McAdams

Shukla

2010

Indian J Urol

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“…Although the application of ESWL in children was first reported in 1986 [15] , ESWL monotherapy for managing staghorn calculi in children was first reported in 1999 by Orsola et al [32] where 11 of 15 children were rendered stone-free. In recently published studies the reported stone-free rates after ESWL increased to 95% for infants and 71–87.5% for children with staghorn calculi [33,34] .…”

Section: Eswl For Staghorn Calculi In Childrenmentioning

confidence: 99%

“…When considering ESWL for kidney stones in children, unlike in PCNL, it appears to be a different condition from that in adults, and recommendations for children cannot be directly inferred from those for adults. This is mainly because staghorn calculi in children represent a smaller stone burden, and that the small body volume of children facilitates better shock-wave transmission, both resulting in superior stone fragmentation and clearance rates [32,34] . In addition, the shorter duration of the disease, greater stone fragility and lower impedance to shock waves might be the possible reasons for better stone fragmentation.…”

Section: Eswl For Staghorn Calculi In Childrenmentioning

confidence: 99%

“…In addition, the shorter duration of the disease, greater stone fragility and lower impedance to shock waves might be the possible reasons for better stone fragmentation. Furthermore, these stones are often present in undilated collecting systems, occupying a relatively smaller volume even for complete staghorn calculi [32,34] . Therefore, unlike in adults, ESWL monotherapy has the potential to be accepted as a suitable treatment option in children with staghorn calculi.…”

Section: Eswl For Staghorn Calculi In Childrenmentioning

confidence: 99%

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The management of staghorn calculi in children

Horuz¹,

Sarıca

2012

Arab Journal of Urology

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ObjectivesTo review reports focusing on the surgical treatment of staghorn stones in children, as despite all the improvements in the surgical treatment of paediatric urolithiasis the management of staghorn calculi still represents a challenging problem in urology practice.MethodsTo evaluate current knowledge about treating staghorn calculi in children, we searched PubMed for relevant articles published between 1991 and 2011, using a combination of related keywords, i.e. staghorn stone, child, kidney calculi, surgical treatment, electrohydraulic shockwave therapy (ESWL), percutaneous nephrolithotomy (PCNL), and open surgery. Reports relating to the treatment of paediatric stone disease in general (open surgery, PCNL, ESWL) were also searched with the same method. Additional references were obtained from the reference list of full-text reports.ResultsAlthough open surgery had been widely used in the past for treating such stones in children, currently it has only limited indications in highly selected patients. Current published data clearly indicate that, in experienced hands, both PCNL and ESWL are now effective methods for treating staghorn calculi in children.ConclusionsDue to advanced techniques and instrumentation, it is now possible to successfully treat staghorn calculi in children, with very limited safety concerns. Currently, while PCNL is recommended as the first-line surgical treatment, ESWL, open surgery and/or combined methods are valuable but secondary options in the treatment of paediatric staghorn calculi.

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“…[35] The incidence of Steinstrasse following ESWL in children without ureteral stents has shown to be very low (significantly lower than for adults). [236] As a result, preoperative stenting is generally reserved for children with solitary kidney, severely obstructing stones, or abnormal anatomy.…”

Section: Extracorporeal Shock Wave Lithotripsymentioning

confidence: 99%

Management of ureteric stone in pediatric patients

Minevich

2010

Indian J Urol

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The management of ureteral stones in children is becoming more similar to that in adults. A number of factors must be taken into account when selecting one's choice of therapy for ureteral stone in children such as the size of the stone, its location, its composition, and urinary tract anatomy. Endoscopic lithotripsy in children has gradually become a major technique for the treatment of ureteral stones. The stone-free rate following urteroscopic lithotripsy for ureteral stones has been reported in as high as 98.5-100%. The safety and efficacy of Holmium:YAG laser lithotripsy make it the intracorporeal lithotriptor of choice. Given its minimally invasive features, extracorporeal shock wave lithotripsy (ESWL) has become a primary mode of treatment for the pediatric patients with reno-ureteral stones. Stone-free rates have been reported from 59% to 91% although some patients will require more than one treatment session for stone clearance. It appears that the first-line of therapy in the child with distal and mid-ureteral stones should be ureteroscopic lithotripsy. While ESWL is still widely considered the first-line therapy for proximal ureteral calculi, there is an increasing body of evidence that shows that endoscopic or ESWL are equally safe and efficacious in those clinical scenarios. Familiarity with the full spectrum of endourological techniques facilitates a minimally invasive approach to pediatric ureteral stones.

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Staghorn Calculi in Children

Abstract: ESWL using the Siemens Lithostar-ULTRA is simple, effective and safe primary treatment in children with staghorn calculi.

Cited by 10 publications

References 17 publications

Pediatric extracorporeal shock wave lithotripsy: Predicting successful outcomes

Pediatric extracorporeal shock wave lithotripsy: Predicting successful outcomes

The management of staghorn calculi in children

Management of ureteric stone in pediatric patients

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