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Extracorporeal shockwave lithotripsy under sedoanalgesia for treatment of kidney stones in infants: a single-center experience with 102 cases.

AbstractOBJECT:
We present the efficacy of shockwave lithotripsy (SWL) therapy administered with sedoanalgesia in infants with kidney stones.
MATERIALS AND METHODS:
We enrolled 102 patients aged 5-24 months who had kidney stones and received SWL therapy under sedoanalgesia using a Siemens Lithostar Modularis device. Patient and stone characteristics, therapy parameters, pain score, complications, discharge time, and follow-ups were registered and evaluated. Pain score was assessed using a Neonatal Infant Pain Score (NIPS). Postanesthetic discharge scoring system (PADSS) was used for the assessments of postprocedural discharge procedure.
RESULTS:
Mean age of the patients was 17.2 ± 6.3 months (5-24 months). Mean stone size was 7.9 ± 3.3 mm (5-23 mm). The most common concomitant metabolic disorders were hypercalciuria and hypocitraturia. The stone-free rates of the infants were 70.6, 87.3, and 99.1 % after the first, second, and third sessions of SWL therapy, respectively. The mean NIPS scores procedure during, and at 1 h after SWL procedure were determined as 0.24 ± 0.45 and 0.34 ± 0.47, respectively. There was no statistically significant difference between two pain score values (P = 0.114). The mean discharge time of patients after the SWL procedure were 108.6 ± 27.9 min. Forty-two patients (41.1 %) were followed up. The follow-up period varied between 8 and 48 months (mean 19.5 months); none of those patients showed evidence of diabetes mellitus, hypertension, or renal function impairment.
CONCLUSIONS:
SWL therapy under sedoanalgesia is a safe and efficient treatment modality that can be administered with low complication rates and high stone-free rates in the treatment of renal stones in infants.
AuthorsSenol Adanur, Tevfik Ziypak, Ali Haydar Yılmaz, Huseyin Kocakgol, Mehmet Aksoy, Turgut Yapanoglu, Ozkan Polat, Yılmaz Aksoy
JournalInternational urology and nephrology (Int Urol Nephrol) Vol. 46 Issue 11 Pg. 2095-101 (Nov 2014) ISSN: 1573-2584 [Electronic] Netherlands
PMID25080207 (Publication Type: Journal Article)
Topics
  • Analgesia (methods)
  • Child, Preschool
  • Conscious Sedation (methods)
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Kidney Calculi (therapy)
  • Lithotripsy (methods)
  • Male
  • Pain Measurement
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

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