SWL in Lower Calyceal Calculi: Evaluation of the Treatment Results in Children and Adults

Göktaş, Cemal; Akça, Oktay; Horuz, Rahim; Okan, Gökhan; Albayrak, Selami; Sarıca, Kemal

doi:10.1016/j.urology.2011.08.005

Cited by 26 publications

(15 citation statements)

References 27 publications

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“…In the same study, the stone-free rate for 1- to 2-cm lower pole stones was 57%. The range of stone-free rates of SWL on lower pole stones is 21-70% [3,4,5,6,7]. SWL is not a surgical procedure; thus, both patients and physicians consider it a noninvasive procedure.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm

et al. 2013

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Objective: To compare the results of percutaneous nephrolithotomy (PCNL), shock wave lithotripsy (SWL), and retrograde intrarenal surgery (RIRS) for 1- to 2-cm lower pole kidney stones. Patients and Methods: This retrospective study was based on data collected from the files of patients between January 2007 and May 2012. The files of 383 patients (221 SWL, 144 PCNL, 38 RIRS) were evaluated. The groups were compared for stone size, success rate, and complication rate using the modified Clavien grading system. Results: The stone burdens of the groups were similar (p = 0.36). The success rates were 76, 94, and 73%, respectively, in SWL, PCNL, and RIRS. The highest stone-free rate was in the PNL group (p < 0.05). When the complication rates were evaluated using the Clavien grading system, they were determined to be 13% in PCNL, 3% in SWL, and 5% in RIRS. Especially GII and GIII complications were more common in the PCNL group (p < 0.05). Conclusion: PCNL seems to be the most successful but most invasive method. However, with relatively low complication rates, SWL and RIRS are other techniques to keep in mind. To determine the first-line treatment, prospective randomized studies with larger series are needed.

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Section: Discussionmentioning

confidence: 99%

Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm

et al. 2013

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“…Several studies have demonstrated a significantly lower success rate after ESWL for lower pole stones than for other kidney locations [24,25]. However, a recent study by Goktas et al [26] reported that ESWL was highly successful for lower calyceal stones in pediatric patients compared with adults. The study suggested that ESWL can be a first-line treatment for managing lower calyceal stones in children.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting the Outcome of Extracorporeal Shock Wave Lithotripsy for Unilateral Urinary Stones in Children: A 17-Year Single-Institute Experience

et al. 2013

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PurposeExtracorporeal shock wave lithotripsy (ESWL) is a first-line treatment for pediatric urinary stone disease. We aimed to determine the factors affecting the outcome of ESWL for unilateral urinary stones in children.Materials and MethodsA total of 81 pediatric patients aged 0 to 16 years with urinary stones treated by ESWL from January 1995 through May 2012 were retrospectively reviewed. All patients were required to have unilateral urinary stone disease. Children who underwent other surgical procedures before ESWL were excluded. Outcomes evaluated after ESWL were the stone-free rate at 3 months after ESWL, success within a single session, and success within three sessions. Factors affecting the success within three sessions were also analyzed.ResultsThe final analysis was for 42 boys and 22 girls (mean age, 9.2±5.2 years). Of these 64 patients, 58 (90.6%) were treated by ESWL without other surgical procedures and 54 (84.4%) were successfully treated within three ESWL sessions. In the multivariate analysis, multiplicity (odds ratio [OR], 0.080; 95% confidence interval [CI], 0.012 to 0.534; p=0.009) and large stone size (>10 mm; OR, 0.112; 95% CI, 0.018 to 0.707; p=0.020) were significant factors that decreased the success rate within three ESWL sessions.ConclusionsMost of the pediatric urinary stone patients in our study (90.6%) were successfully treated by ESWL alone without additional procedures. If a child has a large urinary stone (>10 mm) or multiplicity, clinicians should consider that several ESWL sessions might be needed for successful stone fragmentation.

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“…[3132] In contrast, the results obtained in children (using the small focal size) are excellent. [33] Nevertheless, there are no studies focusing on the use of three different focal zones as proposed by the manufacturer.…”

Section: Recent Developments In Lithotriptersmentioning

confidence: 99%

Extracorporeal shock wave lithotripsy: An opinion on its future

Rassweiler¹,

Rassweiler²,

Frede³

et al. 2014

Indian J Urol

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The development of miniaturized nephroscopes which allow one-stage stone clearance with minimal morbidity has brought the role of shock wave lithotripsy (SWL) in stone management into question. Design innovations in SWL machines over the last decade have attempted to address this problem. We reviewed the recent literature on SWL using a MEDLINE/PUBMED research. For commenting on the future of SWL, we took the subjective opinion of two senior urologists, one mid-level expert, and an upcoming junior fellow. There have been a number of recent changes in lithotripter design and techniques. This includes the use of multiple focus machines and improved coupling designs. Additional changes involve better localization real-time monitoring. The main goal of stone treatment today seems to be to get rid of the stone in one session rather than being treated multiple times non-invasively. Stone treatment in the future will be individualized by genetic screening of stone formers, using improved SWL devices for small stones only. However, there is still no consensus about the design of the ideal lithotripter. Innovative concepts such as emergency SWL for ureteric stones may be implemented in clinical routine.

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SWL in Lower Calyceal Calculi: Evaluation of the Treatment Results in Children and Adults

Cited by 26 publications

References 27 publications

Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm

Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm

Factors Affecting the Outcome of Extracorporeal Shock Wave Lithotripsy for Unilateral Urinary Stones in Children: A 17-Year Single-Institute Experience

Extracorporeal shock wave lithotripsy: An opinion on its future

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