Are there long‐term effects of extracorporeal shockwave lithotripsy in paediatric patients?

Abstract

What's known on the subject? and What does the study add? Extracorporeal shockwave lithotripsy is effective for the treatment of paediatric renal stones with favourable short‐term safety. Extracorporeal shockwave lithotripsy for treatment of paediatric renal stones is also safe for the kidney and the child on long‐term follow‐up. Objective To evaluate the long‐term effects of extracoporeal shockwave lithotripsy (SWL) for treatment of renal stones in paediatric patients. Patients and Methods A database of paediatric patients who underwent SWL monotherapy for treatment of renal stones from September 1990 through to January 2009 was compiled. This study included only patients with follow‐up for more than 2 years. The long‐term effects of SWL were evaluated at the last follow‐up with measurement of patients' arterial blood pressure, estimation of random blood sugar and urine analysis. The results of diastolic blood pressure were plotted against a standardized age reference curve. The treated kidney was examined by ultrasonography for measurement of renal length and detection of stones. The measured renal lengths were plotted against age‐calculated normal renal lengths in healthy individuals. Results The study included 70 patients (44 boys (63%) and 26 girls) with mean age at the time of SWL 6.5 ± 3.6 years (range 1–14). The mean follow‐up period was 5.2 ± 3.6 years (range 2.1–17.5). The mean age at last follow‐up was 11.7 ± 5.3 years (range 4.4–27.5). No patients developed hypertension or diabetes. Only one treated kidney was smaller than one standard deviation of the calculated length. The cause of this was obstruction by a stone in the pelvic ureter 3 years after SWL. Conclusion The long‐term follow‐up after SWL for treatment of renal stones in paediatric patients showed no effect on renal growth and no development of hypertension or diabetes.