MP38-10 EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY VERSUS FLEXIBLE URETEROSCOPY FOR THE MANAGEMENT OF UPPER TRACT URINARY STONES IN CHILDREN:A CASE-CONTROL NON RANDOMIZED STUDY

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy IV1 Apr 2015MP38-10 EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY VERSUS FLEXIBLE URETEROSCOPY FOR THE MANAGEMENT OF UPPER TRACT URINARY STONES IN CHILDREN:A CASE-CONTROL NON RANDOMIZED STUDY Benoit Peyronnet, Alexis Arnaud, Lauranne Tondut, Lucas Freton, Gaetan Berquet, Gregory Verhoest, Olivier Azzis, Benjamin Fremond, and Karim Bensalah Benoit PeyronnetBenoit Peyronnet More articles by this author , Alexis ArnaudAlexis Arnaud More articles by this author , Lauranne TondutLauranne Tondut More articles by this author , Lucas FretonLucas Freton More articles by this author , Gaetan BerquetGaetan Berquet More articles by this author , Gregory VerhoestGregory Verhoest More articles by this author , Olivier AzzisOlivier Azzis More articles by this author , Benjamin FremondBenjamin Fremond More articles by this author , and Karim BensalahKarim Bensalah More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1385AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Current guidelines recommend extracorporeal lithotripsy (ESWL) as first-line treatment of kidney stones <2 cm in children. However, no study has compared the results of ESWL and flexible ureteroscopy (F-URS) in the pediatric population. The objective of this study was to compare the efficacy and morbidity of ESWL and the F-URSS for the management of upper tract urinary stones in children. METHODS All ESWL and F-URS performed in children between 0 and 18 years in a single-institution between 2000 and 2014 were reviewed retrospectively. Only procedures performed to treat upper tract urinary stones (upper ureter or kidney) were included in the study. Preoperative and perioperative outcome data were compared between the ESWL and F-URS groups using the χ2 test or Fisher test for categorical variables and the Mann-Whitney test for quantitative variables. A patient was considered to be stone free (SF) in the absence of stone fragment > 4mm on the imaging performed at three months postoperatively. RESULTS Over the study period 100 ESWL and 46 F-URS were conducted in children. The ESWL and F-URS groups were comparable in terms of stone size (14.6 vs. 13.2 mm, p = 0.32) but there were more multiple stones (31% vs. 57%; p = 0.003) and lower pole calculi (14% vs. 37%; p = 0.003) in the F-URS group. The SF rates after one procedure was almost two times higher in the F-URS group compared to the ESWL group (37% vs. 21%; p = 0.04) without increasing the complication rate (23% vs. 16% ; p = 0.31) but with a more frequent use of general anesthesia (100% vs. 81%; p = 0.0005) and a monger length of stay (1.4 vs. 0.9 days; p = 0.02). CONCLUSIONS This study is the first to compare the results of ESWL and F-URS for the treatment of upper tract urinary stones in children. F-URS provides a higher SF rate despite more complex urinary stones (multiple, lower pole,….) without increasing morbidity. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e450 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benoit Peyronnet More articles by this author Alexis Arnaud More articles by this author Lauranne Tondut More articles by this author Lucas Freton More articles by this author Gaetan Berquet More articles by this author Gregory Verhoest More articles by this author Olivier Azzis More articles by this author Benjamin Fremond More articles by this author Karim Bensalah More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...