Comparison of extracorporeal shock wave lithotripsy for inferior caliceal calculus between children and adults: a retrospective analysis--why do results vary?

Abstract

OBJECTIVE:

To retrospectively evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) for inferior caliceal calculi ≤ 20 mm in size and compare the results between children and adults.

MATERIALS AND METHODS:

From January 2004 to January 2012, ESWL was performed for inferior caliceal calculi in 230 children and 1006 adults. The Dornier compact alpha-K1025163 (Dornier Med Tech) was used. The success rates, number of ESWL sessions required, and auxiliary procedures used were evaluated in a comparative manner.

RESULTS:

The overall stone-free rate (for both stone sizes) was 82.2% for children and 40% for the adults. Of the children, 17% had a residual stone compared with 47.8% of the adults. ESWL was unsuccessful in 0.8% of children and 12.2% of adults. The mean number of ESWL sessions required in children and adults was 1.43 (range 1-4) and 2.13 (range 1-4), respectively. Repeat treatment was required in 31% of the children and 65% of the adults. Auxiliary procedures were required in 5.2% of the children and 16.2% of the adults. Complications were seen in 5.6% of the children and 15% of the adults.

CONCLUSION:

The results of ESWL for inferior caliceal calculi ≤ 20 mm in adults remains poor but not so in children. Children can achieve high stone-free rates, require a fewer number of ESWL sessions than adults to be stone free, and have a lower need for repeat treatment and auxiliary procedures, and have fewer complications.

• Authors: Swarnendu Mandal, Satya N Sankhwar, Manish Kumar Singh, Rohit Kathpalia, Vishwajeet Singh, Apul Goel, Bhupendra P Singh, Divakar Dalela
• Journal: Urology (Urology) Vol. 80 Issue 6 Pg. 1209-13 (Dec 2012) ISSN: 1527-9995 [Electronic] United States
• PMID: 23040726 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Child
• Humans
• Kidney Calculi (surgery)
• Kidney Calices
• Lithotripsy
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Young Adult