Comparison of efficacy and safety of ESWL in paediatric and adolescent versus adult urolithiasis: A single center 5-year experience from a tertiary care hospital

Abstract

ObjectiveTo retrospectively compare the efficacy and safety of extra-corporeal shock wave lithotripsy (ESWL) for renal/upper ureteric calculi in pediatric/adolescents (group 1) vs adults(group 2). Subjects and methodsMedical records of 948 patients who underwent ESWL for renal/upper ureteric calculi at a tertiary care center in North India from January 2012 to December 2017 (five years). The Dornier compact alpha-K1025163 (Dornier Med Tech) equipment was used for ESWL. We evaluated the stonefree rates, the number of ESWL sessions, use of ancillary procedures and complications between the two groups. ResultsA total of 110 patients were in group 1 and 838 patients were in group 2. The mean stone size in group 1 patients was 1.20±1.18cm2 while in group 2 it was 1.49±0.37cm2. The stone clearance rate was 85/110 (77%) for the group 1 and 545/838(65%) for group 2 patients. In group 1, a second session was required in 28/110 (25.4%) patients and the third session was required in 5/110 (4.5%) patients while in the adult group two sessions were required in 175 (20.8%) and three sessions were required in 24 (19.2%) patients. The overall complication rate in group 1 was 15/110 (13.63%) and in the group, II was 105/838 (12.5%). No statistical difference was found between post-ESWL complications and use of ancillary procedures (DJ stenting/PCNL) (p=0.067). ConclusionIn renal/upper ureteric calculi ESWL has got better efficacy, comparable safety and requires equivalent ancillary procedures in children and adolescents compared to adults.