Editorial comment

Abstract

This important communication by Demirkesen et al. answers several questions regarding pediatric stone treatment, but also raises interesting questions. In their study, the authors found that ESWL was equally effective for stones in all locations, although the stone burdens were less for lower pole caliceal stones compared with renal pelvic stones. The communication supports the use of ESWL, as opposed to percutaneous stone removal, for stones less than 2 cm. This conclusion, however, lacks certain information that makes it difficult to translate to other practices. First, no stone analysis was available. Second, no comparison was made among the types of commercially available lithotriptors, which may have marked differences in efficacy. Third, the infundibulopelvic angle, infundibular length, and infundibular width may also be strong determinants of stone passage. 1 Elbahnasy A.M. Clayman R.V. Shalhav A.L. et al. Lower-pole caliceal stone clearance after shockwave lithotripsy, percutaneous nephrolithotomy, and flexible ureteroscopy impact of radiographic spatial anatomy. J Endourol. 1998; 12: 113-119 Crossref PubMed Scopus (107) Google Scholar The conclusions in this paper leave me somewhat satiated, but still eager for further information on which to feast. Additional studies are needed to determine the efficacy of pediatric ESWL according to stone composition, lithotripter type, and pelvicaliceal anatomy. The development of such a nomogram would truly be an advance in the treatment of urolithiasis. Efficacy of extracorporeal shock wave lithotripsy for isolated lower caliceal stones in children compared with stones in other renal locationsUrologyVol. 67Issue 1PreviewTo evaluate the efficacy of extracorporeal shock wave lithotripsy (ESWL) monotherapy for isolated lower caliceal calculi in a pediatric age group and compare it with that for isolated middle/upper caliceal and renal pelvic calculi. Full-Text PDF