Stone-free-rate after extracorporeal shockwave lithotripsy in the management of pediatric renal stones in lower pole and other locations - a comparative study

Objective: To determine a difference in the stone-free-rate among different renal locations in children after extracorporeal shockwave lithotripsy [ESWL]

Study Design: A descriptive study

Place and Duration of Study: Urology Department, Shifa International Hospital, Islamabad, Pakistan, from January 2007 to June 2015

Methodology: The study included children who underwent ESWL, divided into three groups based on location of stones in kidney as group A [lower pole stones], group B [upper and mid pole stones] and group C [renal pelvis stone], respectively. ESWL was done by standard technique using Storz Modulith SLX lithotripter 3rd generation. Data was collected by chart review. SPSS version 16 was used for data analysis

Results: Among 76 children with mean age of 7.55 +/- 4.16 years, 55 [72.4%] were males whereas 21 [27.6%] were females. Mean stone size was 1.08 +/- 0.59 cm. There were 34, 17 and 25 cases in groups A, B and C, respectively. Post-ESWL stone-free-rate was 47% in lower pole stones, 70.58% in upper and mid pole stones, and 68% in renal pelvis stones. Hematuria was seen in one patient from each group, sepsis in two patients from each of the mid pole/upper pole and lower pole group, while Steinstrasse in one patient from each group

Conclusion: ESWL is a safe and effective way of treating renal stones in all poles in pediatric population

Ureteroscopy for management of ureteric stones in children - a single centre experience

Objective: To determine the outcomes of pediatric patients who underwent ureteroscopic removal of ureteric stones in terms of stone free rates and complications

Study Design: Descriptive case series

Place and Duration of Study: Urology Department at Shifa International Hospital, Islamabad, from January 2012 to December 2014

Methodology: A retrospective analysis of 37 patients, who underwent ureteroscopy for the treatment of ureteral calculi at the study centre, was conducted. Data regarding mean stone size, stone location, stone clearance and complications was recorded on specified proforma. Data was analysed on SPSS version 16

Results: Thirty-seven children with mean age of 8.36 +/- 5.17 years were included. Twenty-five [67.6%] patients were male, whereas 12 [32.4%] patients were female. Mean stone size was 10.01 +/- 6.24 mm. Location-wise 25 [67.56%] patients had upper ureteric stones, 5 [13.5%] patients had mid ureteric stones and 7[18.9%] patients had distal ureteric stones. Twenty two [59.5%] children underwent one procedure, while 15 [40.5%] children underwent relook ureteroscopies. Second relook ureteroscopy was done in 13/25 [52%] patients, 1/5 [20%] patient and 1/7 [14.28%] patient in upper, mid and lower ureteric stones, respectively. Overall stone clearance rate was 35/37 [94.59%] after first procedure. Mean operative time was 52.54 +/- 12.39 minutes. Urosepsis was seen in 2 patients. No major complications were seen. After the second URS procedure, stone free rate was 100%

Conclusion: Ureteroscopy is a safe and effective procedure in children in terms of stone free rate and complications