Efficacy of extracorporeal shock wave lithotripsy in paediatric urolithiasis

ABSTRACT

To determine the efficacy of extracorporeal shock wave lithotripsy with reference to stone size and radiodensity in children. Design: Patients of either sex were treated with ESWL from April 1994 to January 1995. Setting: Department of Urology, Mayo Hospital, Lahore. Twenty five patients of age below twelve years presenting with renal, ureteric and bladder stone of size between '5-20 mm along their long axis were included. Main outcome measure: Efficacy. Single treatment session was sufficient in 40%, two in 28% and three in 8% patients. No stone clearance was observed in 20% patients after three sessions and 4% patients had to be operated after one session. There were 60% low density stones, 28% stones were equibone dense and 12% stones had radiodensity more than that of bone. Among low density stones 77.78% renal, 100% ureteric and 100% bladder stones were successfully fragmented with overall success rate of 86.6% [13/15]. Out of equibone density stones 14.28% renal, 14.28% ureteric and 42.86% bladder stones were successfully fragmented. So the success rate for equibone dense stone was 71.4% [5/7]. There were 3 [12%] stones with radiodensity greater than that of bone and had successful fragmentation rate of 33.33% [1/3]. Kidney stones 5-10mm in size were cleared in aII [100%] cases after one treatment session and those 11-15mm in size needed more shock waves on an average 1.8 treatment session. Stones 15-20 mm in size required 2-3 treatment session. Success rate for 5-10mm size ureteric stones was 100% but it was 0% for those of size 11-15mm. Bladder stones which measured 10-15 mm in size required one session while those measuring 15-20 mm were fragmented during1.16 treatment session. ESWL is an effective modality for treatment of urinary stones as monotherapy in selected patients