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19–22 APRIL, 2017, BARCELONA, SPAIN
10:26–10:29
S22-3 (PP)
SHOCK WAVE LITHOTRIPSY TREATMENT
IN THE PEDIATRIC POPULATION COMPARED WITH ADULTS
– A 14 YEARS’ EXPERIENCE
Ariel ZISMAN
1
, Oleg GOLDIN
2
, Kamil MALSHY
2
, Eden AMIEL
2
, Akram ASSADI
2
,
Pinhas M. LIVNE
2
, Gilad E. AMIEL
2
and Michael MULLERAD
2
1) Rambam Health Care Campus, Urology, Haifa, ISRAEL - 2) Rambam Health Care Campus, Technion Faculty
of Medicine, Urology, Haifa, ISRAEL
INTRODUCTION
Evaluating the results of Shock Wave Lithotripsy (SWL) for renal and ureteral stones in pediatric
patients in comparison with adults.
MATERIAL AND METHODS
Between 2002-2016 121 children underwent 127 SWL procedures using Dornier HM3 and DLS2.
Average age was 11.5±5.1 years, (median age 12 range 2-18). A successful treatment was defined
as a stone-free status or stone fragments smaller than 5 mm without the need of further treat-
ment. We evaluated the success rate after one or two SWL’s in a time period of 6 months. Results
were compared to a cohort of 427 adults (average age 50±14.4 years). Groups differed in age,
gender distribution (boys 57%, men 67%), stone location (renal pelvis and upper ureter - in children
31% and 6.6%, in adults 21% and 21% respectively). Evaluation of treatment outcome was done
4-6 weeks after the procedure using renal ultrasound and abdominal plain film.
RESULTS
107 children had follow-up information available. Average stone size was 10.6 mm (range 4-30 mm;
median size 9 mm). Success rate after the first and second SWL’s were 68% and 78% (73 and
83 children) respectively. In the adult group average stone size was 11 mm (5-25 mm; median size
10 mm). A 67.4% success rate was observed after first SWL (insufficient data regarding 2
nd
SWL).
Complications in children compared with adults included: Hydronephrosis (8.5% vs 5%; NS), with
only 2 cases of admission following obstruction in the pediatric group, fever (5% vs 5.5%; NS) and
perinephric hematoma (1% vs 2%; NS). Success rate after a single SWL were similar between
children and adults (68.2% and 67.4%, P=0.91).
CONCLUSIONS
SWL for renal and ureteral stones in the pediatric population is safe with similar results and compli-
cation rates as in adults.