Abstract

Purpose: Extracorporeal shock wave lithotripsy (ESWL) is a treatment procedure which is frequently used in adults and it is also getting more popular in the pediatric population. The aim of this study was to retrospectively evaluate the results of the treatment of renal and ureteral calculi in children using ESWL.

Material and Methods: Between December 2008 and December 2010, 91 renal units of 89 patients with renal and ureteral calculi were treated with ESWL. There were 52 (58.42 %) male and 37 female (41.57 %) patients with a mean age of 6. 98 (range; 1-16 years). years The procedure was performed using general anesthesia or sedoanalgesia in patients under 12 years old and intramuscular analgesics in patients older than 12 years of age. Patients were also followed up on every 10-15 days on a regular basis with direct urinary system X-ray (KUB) and ultrasound screening (USG). ESWL was performed again in recalcitrant cases. The ESWL sessions lasted between 30 and 45 minutes.

Results: Total of 91 renal units were treated with ESWL. In 9 patients, ESWL procedure was unsuccessful. Of these, 4 patients were treated with percutaneous nephrolithotomy (PNL), and 3 with lithotripsy using URS. Two of them were treated with open surgical procedures. In this study, the success rate (elimination of calculi) of ESWL was 90. 10 % (82/91).

Conclusion: ESWL has many advantages such as rapid recovery time,application as an outpatient procedure with a minimal harm to renal parenchyma. It can also be performed more than once should the need arise. Taking higher recurrence rate of urinary system calculi in children into consideration, as a non-invasive procedure ESWL may be the standard treatment of choice in this patient population. We believe that ESWL is an effective and safe procedure in the management of urinary system calculi in pediatric patient population.