@Article{,
AUTHOR = {Prem A. Ramakrishnan, Mohammed Medhat, Younis H. Al-Bulushi, Priti Nair, Ahmed Al-Kindy},
TITLE = {Extracorporeal shockwave lithotripsy in infants},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {14},
YEAR = {2007},
NUMBER = {5},
PAGES = {3684--3691},
URL = {http://www.techscience.com/CJU/v14n5/62362},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> Pediatric urolithiasis is relatively uncommon and limited information is available on the application of minimally invasive management modalities in young children. We present a single centre experience with extracorporeal shockwave lithotripsy (ESWL) for infants with upper urinary tract calculi.
<br/><b>Material and methods:</b> A total of 74 infants aged 3 months to 24 months with upper urinary tract calculi were treated with ESWL under general anesthesia using the Wolf 2500 and the 2501 Piezolith lithotriptors over a 14 and a half-year period. Patient and stone characteristics, risk factors for urolithiasis, treatment parameters, clinical outcomes and long-term follow-up were assessed and recorded.
<br/><b>Results:</b> The mean patient age was 14.5 (range 3 to 24) months. The mean renal stone size was 18.2 (range 7 to 32) mm while the mean ureteral stone size was 9.4 (range 5 to 14) mm. Metabolic abnormalities, structural anomalies and urinary tract infections were identified as contributory factors for stone formation in 34% of the infants. At the 3-month follow-up there was an overall successful outcome in 72 infants (97%) that included 65 (88%) who were rendered stone-free and 7 (9%) who had clinically insignificant stone fragments. Retreatment was required in 27 (35%) patients, auxiliary procedures after ESWL were needed in 5 (7%) and secondary operative procedures were required in 2 (3%). Major complications were encountered in 5 (7%) patients that included complete ureteral obstruction with sepsis in 2, partial ureteral obstruction in 1 and febrile urinary tract infection in 2 other children. Long-term follow-up was recorded in 39 infants: 8 developed recurrent stones, 2 had stone regrowth and 1 developed mild hypertension but none had significant deterioration of renal function.
<br/><b>Conclusions:</b> ESWL is an effective treatment for upper urinary tract calculi in infants. In the short-term, complications are minimal but long term follow up is needed.},
DOI = {}
}