Childhood urolithiasis: urological management of upper tract calculi in the era of extracorporeal shock-wave lithotripsy.

Abstract:

OBJECTIVE:To evaluate the management of urolithiasis in children since the development of extracorporeal shock-wave lithotripsy (ESWL). METHODS:Between 1988 and 1994, 37 children, aged from 2 to 15 years (mean 10), with upper tract urolithiasis were evaluated and treated. Lithogenic metabolic disorders or anomalies of the urinary tract were present in 11 children (30%) Urolithiasis was multiple in 9 cases and bilateral in 2 cases. A total of 47 renal (30) or ureteral (17) stones were managed, of which 5 were partial or complete staghorn calculi. Initial treatment was surgery in 4 cases (1 nephrectomy, partial nephrectomy and 2 pyelolithotomies) and piezoelectric ESWL in 43 cases. RESULTS:The overall ESWL success rate was 82.2%, with auxillary endoscopic procedures in 3 cases. ESWL failures required surgical stone removal in 5 cases, endoscopic ureterolithotripsy in 1 case and electrohydraulic ESWL in 1 case. Residual fragments after pyelolithotomies were also treated by ESWL. CONCLUSION:ESWL is the mainstay of treatment of childhood upper tract urolithiasis, but other therapeutic methods retain specific indications. Its application requires great vigilance and its long-term effects are uncertain. It is therefore important to rule out any underlying pathology and where possible to prevent further stone formation.

journal_name

Urol Int

journal_title

Urologia internationalis

authors

Robert M,Drianno N,Guiter J,Averous M,Grasset D

doi

10.1159/000282882

subject

Has Abstract

pub_date

1996-01-01 00:00:00

pages

72-6

issue

2

eissn

0042-1138

issn

1423-0399

journal_volume

57

pub_type

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