Open Access

ARTICLE

Ungated extracorporeal shock wave lithotripsy: safe and effective in the pediatric population

Jeffrey S. Palmer

Center for Pediatric andAdolescent Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Children’s Hospital, Cleveland, Ohio, USA
Address correspondence to Dr. Jeffrey S. Palmer, Center for Pediatric and Adolescent Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Children’s Hospital, 9500 Euclid Avenue, Q10-1, Cleveland, OH 44195 USA

Canadian Journal of Urology 2009, 16(6), 4924-4926.

Abstract

Purpose: Ungated extracorporeal shock wave lithotripsy (SWL) is unsynchronized to the patient's electrocardiogram. Although ungated extracorporeal shock wave lithotripsy (SWL) is associated with cardiac arrhythmias in adults, the incidence of arrhythmias in children has not been established. We report on the safety and efficacy of ungated SWL of renal calculi in children.
Materials and methods: We evaluated all children less than 18 years of age undergoing ungated SWL for renal calculi. Lithotripsy with gradual incremental energy increase was used to treat the stones. Patients were monitored for arrhythmias and other standard monitoring intraoperatively and postoperatively.
Results: Twenty-four consecutive children (10 boys and 14 girls) between 3.5 and 17 years of age underwent 32 ungated SWL procedures for renal calculi. The stone size ranged from 5mm to 19mm. No patient had cardiac arrhythmias or other intraoperative complications, required to have the procedure terminated prematurely, or conversion to gated SWL. The overall stone free rate was 87% based on radiographic imaging.
Conclusions: This series supports our initial series that ungated SWL is safe and efficacious in children less than 18 years of age. The arrhythmias associated with adults do not appear to occur in children undergoing ungated SWL.

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