The Effect of a Double-J Stent in the Treatment of Kidney Stones Larger Than 10 mm in Children Under 13 Years, Using Extracorporeal Shock Wave Lithotripsy (ESWL)

Abstract

Background: Kidney stones were previously rare among children, but now its prevalence and frequency among children has increased. Objectives: The aim of this study was to investigate the effect of a double-J stent on the treatment of kidney stones larger than 10 mm in children under 13 years, using extracorporeal shock wave lithotripsy. Patients and Methods: This double blind clinical trial study was conducted on 68 children younger than 13 years with renal calculi at pelvic, referred to Tohid hospital in Sanandaj during 2010 - 2014. The patients were randomly divided into two groups: the double-J stent group (34 patients) and the control group (34 patients). 2000 shock waves were given during each period to all subjects. Data were analyzed using SPSS version 18, and descriptive statistics (frequency, ratio, mean, and standard deviation) were collected. Results: The stone sizes of the intervention and control groups were 13.76 ± 2.62 mm 13.91 ± 2.79 mm, respectively (P = 0.69). In 58.8% of the children in the intervention group and 76.5% of those in the control group, the right kidney was involved (P = 0.12). In terms of postlithotripsy outcome frequency, including fever, hospitalization and steinstrasse, there were no statistically significant difference between the intervention and the control groups (P > 0.05). The frequency of urinary tract infection in the intervention group and the control group was 23.5% and 5.9%, respectively, meaning there was a statistically significant difference between the intervention and the control groups (P = 0.04). Conclusions: The kidney stone clearance rate in children with and without using the stent was almost equal. Considering the problems of kidney stents and additional charges, extracorporeal shock wave lithotripsy (ESWL) without stents is recommended for treatment of 8 to 15 mm kidney stones