Ureteroscopy for treatment of ureteral stones in children: factors influencing the outcome.

Purpose: Extracorporeal shock wave lithotripsy (ESWL) is a first-line treatment for pediatric urinary stone disease. We aimed to determine the factors affecting the outcome of ESWL for unilateral urinary stones in children. Materials and Methods: A total of 81 pediatric patients aged 0 to 16 years with urinary stones treated by ESWL from January 1995 through May 2012 were retrospectively reviewed. All patients were required to have unilateral urinary stone disease. Children who underwent other surgical procedures before ESWL were excluded. Outcomes evaluated after ESWL were the stone-free rate at 3 months after ESWL, success within a single session, and success within three sessions. Factors affecting the success within three sessions were also analyzed. Results: The final analysis was for 42 boys and 22 girls (mean age, 9.2±5.2 years). Of these 64 patients, 58 (90.6%) were treated by ESWL without other surgical procedures and 54 (84.4%) were successfully treated within three ESWL sessions. In the multivariate analysis, multiplicity (odds ratio [OR], 0.080; 95% confidence interval [CI], 0.012 to 0.534; p=0.009) and large stone size (＞10 mm; OR, 0.112; 95% CI, 0.018 to 0.707; p=0.020) were significant factors that decreased the success rate within three ESWL sessions. Conclusions: Most of the pediatric urinary stone patients in our study (90.6%) were successfully treated by ESWL alone without additional procedures. If a child has a large urinary stone (＞10 mm) or multiplicity, clinicians should consider that several ESWL sessions might be needed for successful stone fragmentation.

/pdf/factors-affecting-the-outcome-of-extracorporeal-shock-wave-22g0e9w3tc.pdf

Factors affecting the outcome of extracorporeal shock wave lithotripsy for unilateral urinary stones in children: a 17-year single-institute experience.

There are several special situations in which urinary lithiasis presents management challenges to the urologist. An in-depth knowledge of the pathophysiology, unique anatomy, and treatment options is crucial in order to maintain good health in these patients. In this review, we summarize the current literature on the management of the following scenarios: bladder stones, stones in bowel disease, during pregnancy, in association with renal anomalies, with skeletal deformities, in urinary diversions, and in children.

Stones in special situations

The extracorporeal shockwave lithotripsy (ESWL) remains the most common first line of treatment for renal stones in the pediatric population. The purpose of this study is to evaluate and compare the outcomes of the ESWL and mini-percutaneous nephrolithotomy (mini-PCNL). A total of 108 patients younger than 12 years of age with 1–2 cm single renal stone (pelvic or calyceal) were randomized into two groups, each containing 54 patients. Patients in group A were subjected to mini-PCNL using 16.5 Fr percutaneous sheath while those in group B underwent ESWL using Dornier Compact Sigma. The stone-free rate (SFR) after first session was 88.9% (48 cases) and 55.6% (30 cases) for groups A and B, respectively. The difference is highly statistically significant P = 0.006. Two patients (3.7%) in group A needed 2nd session of PCNL, while 18 patients (33.3%)in group B needed a 2nd session, of theses 18 patients six patients needed a 3rd session of ESWL. After the third session of ESWL and second look PCNL the stone-free rates were 92.59% (50 cases) and 88.89% (48 cases) for groups A and B, respectively, (P = 0.639), which is statistically insignificant. The mean hospital stay and fluoroscopy exposure were significantly longer in the mini-PCNL group. The complication rate in groups A and group B were (22.2%) and (14.8%), respectively, which is statistically insignificant (P = 0.484). According to Clavien grade of complications mini-PCNL is a safe procedure, and after three session of ESWL, mini-PCNL has a similar stone-free rate with a lower retreatment rate. However, the mini-PCNL has more radiation exposure, and requires a longer hospital stay.

Is mini-percutaneous nephrolithotomy a safe alternative to extracorporeal shockwave lithotripsy in pediatric age group in borderline stones? a randomized prospective study.

PURPOSE To retrospectively evaluate the efficacy of extracorporeal shock wave lithotripsy (ESWL) by age and current condition as a first-line treatment for pediatric and adolescent urolithiasis. MATERIALS AND METHODS The computerized records of 55 children were retrospectively reviewed from March 1991 to July 2007. The children were below 18 years of age and had undergone ESWL monotherapy for urolithiasis. There were 36 boys (65.5%) and 19 girls (34.5%), with a mean age of 8.5 years (range, 0.5-18 years). There were 24 patients aged 7 years or less and 31 patients aged more than 7 years. RESULTS The mean size of the stones was 9.48 mm (range, 4-22 mm). The overall success rate of ESWL was 90.9% (50 children). The mean number of ESWL sessions was 2.02 (range, 1-10). The mean number of ESWL sessions for the patient group aged 7 years or less was 1.16 (range, 1-2) and that for the patient group aged more than 7 years was 2.97 (range, 1-10; p=0.037). There was also a statistically significant difference in the mean number of ESWL sessions between the younger and older patients who needed general anesthesia (1.16 vs. 2.2 sessions, respectively; 0.042). CONCLUSIONS In the patient group aged 7 years or less, the number of ESWL sessions and the complication rate were comparable with those for endoscopic management. Thus, ESWL is an effective first-line treatment modality for patients aged less than 7 years.

/pdf/efficacy-of-extracorporeal-shock-wave-lithotripsy-in-551dmf5kqg.pdf

Efficacy of Extracorporeal Shock Wave Lithotripsy in Pediatric and Adolescent Urolithiasis

In this study, we retrospectively analyzed our experience with extracorporeal shock wave lithotripsy (ESWL) in children with ureteric stones. Between 1997 and 2008, 115 children with ureteral stones were treated by ESWL in our department. There were 67 boys and 48 girls with a mean age of 7.2 ± 4.3 years. There were 53 (46.1%) patients with proximal ureteric stones, 16 (13.9%) with mid-ureteral stones and 46 (40.0%) with distal ureteral stones. The stone size ranged from 4 to 21 mm with a mean of 7.38 mm. Children with proximal stones were treated in the supine position, while children with mid and distal ureteric stones were treated in the prone or supine position. Stone-free rate at 3 months was 94.8%, the re-treatment rate 15.7%, and overall efficacy quotient (EQ) was 83%. SWL failed in six children (5.2%). There was no significant difference in stone-free rates at 3 months between different groups classified by location and stone size. There were no serious side effects. Our results indicate that ESWL with highly satisfactory stone-free rates and negligible complications can be considered as a first-line treatment for ureteric stones in the pediatric age group.

Efficacy of extracorporeal shock wave lithotripsy for ureteral stones in children

To compare the efficacy and safety of Shockwave lithotripsy (SWL) for upper urinary tract stones of various locations in children. Between 1997 and 2008, a total of 311 children (average age: 7.9 ± 4.4 years, ranged from 6 months to 16 years) with upper urinary tract stones were treated by SWL using Dornier Compact S lithotripter at our department. Of those patients, 196 had renal stones (pelvic, 53; upper and mid calices, 75; lower calices, 68) with an average size of 9.42 ± 7.1 mm, and 115 had ureteral stones (proximal, 53; mid, 16; distal, 46) with an average size of 7.38 ± 5.87 mm. Overall stone-free rates of renal stones and ureteral stones at 3 months were 95.8% and 94.8% with 83.5% and 79.5% of efficacy quotient (EQ), respectively. In renal stone groups, the EQ for renal pelvic stones was 89.2%, for middle and upper calyx stones was 92.5%, which was higher than 71.9% for lower calices stones. In ureteral stone groups, the 82.3% of EQ for proximal ureteral stones and 83.0% for distal ureteral stones were higher than 63.6% for middle ureteral stones. Patients with larger stones had significant higher re-treatment rate (P < 0.05) and lower EQ than small stone groups. No serious side effect happened in the study. SWL for both renal stones and ureteral stones in pediatric group have comparable efficacy and safety, except that stones in lower calices and middle ureters have lower EQ than those in other locations.

Comparison of efficacy and safety of shockwave lithotripsy for upper urinary tract stones of different locations in children: a study of 311 cases

Greater and Lesser Ischiadic Foramina as Path of Shock Wave Lithotripsy for Distal Ureteral Stone in Children

Comparison of efficacy of German and Chinese electromagnetic shock wave lithotripters: Dornier Compact S vs Huikang MZ-SWL-V.

The overall stone-free rate at 3 months, retreatment rate, and ancillary procedure rate for Dornier Compact S were 95.9%, 13.4%, and 2.2%, respectively, and they were 85%, 29.6%, and 10.2%, respectively, for Huikang MZ-SWL-V. The overall efficiency quotients of Dornier Compact S and Huikang MZ-SWL-V were 83% and 60.8%, respectively. However, the pain scores in the Dornier group (6-10) were higher than those in the Huikang group (1-5). Three clinically significant subcapsular hematomas were detected in the Dornier group but there were none in the Huikang group. CONCLUSIONS Dornier Compact S is more effective than Huikang MZ-SWL-V, but SWL with Huikang machine could be performed with milder pain and without analgesia, and a lower significant hematoma rate was observed in Huikang group. UROLOGY 78: 1240‐1243, 2011. © 2011 Elsevier Inc.

Endourology and Stones Comparison of Efficacy of German and Chinese Electromagnetic Shock Wave Lithotripters: Dornier Compact S vs Huikang MZ-SWL-V

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Ying Wang

Author Tools

Chat about Author