Abstract
BackgroundESWL is still considered as the first favorable therapeutic option for urinary stone disease with acceptable effectivity. However, factors associated with favorable outcome have not been widely studied in pediatrics due to the small number of urinary stone prevalence. The aim of this study is to evaluate the factors associated with the success rate of pediatric ESWL in our center according to immediate stone-free rate and 3-month stone-free rates.MethodsThis is a retrospective cohort study of children less than 18 years who had ESWL for urolithiasis from January 2008 until August 2015. Patient’s characteristics including age, gender, BMI, stone location, stone length, stone burden, stone opacity, and number of ESWL sessions were gathered from the medical record. Nutritional status was determined according to the Centers for Disease Control and Prevention BMI curve. The outcome of this study was the factors related to the success rate in pediatric ESWL.ResultsExtracorporeal shock wave lithotripsy was done for 36 patients and 39 renal units (RUs) with mean age of 13.7 ± 4.3 years old, height of 1480 ± 16.0 cm, and BMI of 20.0 ± 3. Of 36 patients included, 39 renoureteral units (RUs) and 46 ESWL sessions were recorded. The mean overall treatment was 1.2 ± 0.5 sessions with mean stone length of 11.1 ± 6.3 mm and stone burden of 116.6 ± 130.3 mm2. Within 3 months of follow-up, we recorded that the overall 3-month success rate was 100%, while the overall 3-month stone-free rate was 66.7%. Stone length (p < 0.001 and p < 0.001), stone perpendicular length (p < 0.001 and p < 0.001), and stone burden (p < 0.001 and p = 0.001) were found to be significantly associated with immediate success and 3-month stone-free status, respectively.ConclusionsESWL is an effective and safe modality to treat pediatric urolithiasis cases. Stone length, stone perpendicular length, and stone burden were found to be associated with immediate success and 3-month stone-free status after pediatric ESWL treatment.
Highlights
ESWL is still considered as the first favorable therapeutic option for urinary stone disease with acceptable effectivity
The aim of this study is to evaluate the factors associated with the success rate of pediatric ESWL in our center
3 Results A total of 36 patients and 39 renoureteral units were treated in 46 ESWL sessions
Summary
ESWL is still considered as the first favorable therapeutic option for urinary stone disease with acceptable effectivity. Factors associated with favorable outcome have not been widely studied in pediatrics due to the small number of urinary stone prevalence. Pediatric stone disease is a somewhat rare condition and often caused by metabolic disturbance [1]. It counts only 2–3% globally with prevalence ranging from 1:1000 to 1:7600 in various geographic regions in the USA alone [1–3]. First reported by Newman et al [3], ESWL use for pediatric stone cases was astonishingly effective, with low complication, and shorter length of hospitalization compared to other treatments [1, 3]. The reported retreatment rate was 13.9–53.9%, and the rate of treatment needing auxiliary procedure needed was between 7 and 33% [5, 6]
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