Extracorporeal Shock Wave Lithotripsy: Principles of Fragmentation Techniques

Complications
Incidence (%)
Renal colic
2–19
Fever
0.8–8.5
Urinary tract infection
1.2–7.7
Stone street
1.1–17.4
Urethral stone
<1
Dermal ecchymosis/bruises
0–100
Perirenal hematoma
<1
Enteric wall hematoma
<1
Gross hematuria
11.3
Hemoptysis
3 case reports

Conclusion

In the era of minimally invasive surgical approaches to stone disease, SWL is the primary treatment option for most of the children. Recent data and experience revealed its safety and efficacy. Complications are mostly minor and self limiting. Appropriate patient selection is important to minimize the failure rates and adverse effects.
References
1.
Newman DM, Coury T, Lingeman JE, Mertz JH, Mosbaugh PG, Steele RE, et al. Extracorporeal shock wave lithotripsy experience in children. J Urol. 1986;136(1 Pt 2):238–40.PubMed
2.
Aldridge RD, Aldridge RC, Aldridge LM. Anesthesia for pediatric lithotripsy. Paediatr Anaesth. 2006;16(3):236–41.PubMedCrossRef
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Erden IA, Artukoglu F, Gozacan A, Ozgen S. Comparison of propofol/fentanyl and ketamine anesthesia in children during extracorporeal shockwave lithotripsy. Saudi Med J. 2007;28(3):364–8.PubMed
4.
Eker HE, Cok OY, Ergenoğlu P, Ariboğan A, Arslan G. IV paracetamol effect on propofol-ketamine consumption in paediatric patients undergoing ESWL. J Anesth. 2012;26(3):351–6.PubMedCrossRef
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Koruk S, Mizrak A, Gul R, Kilic E, Yendi F, Oner U. Dexmedetomidine-ketamine and midazolam-ketamine combinations for sedation in pediatric patients undergoing extracorporeal shock wave lithotripsy: a randomized prospective study. J Anesth. 2010;24(6):858–63.PubMedCrossRef
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McLorie GA, Pugach J, Pode D, Denstedt J, Bagli D, Meretyk S, et al. Safety and efficacy of extracorporeal shock wave lithotripsy in infants. Can J Urol. 2003;10:2051–5.PubMed
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Dogan HS, Tekgul S. Management of pediatric stone disease. Curr Urol Rep. 2007;8:163–73.PubMedCrossRef
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Kurien A, Symons S, Manohar T, Desai M. Extracorporeal shock wave lithotripsy in children: equivalent clearance rates to adults is achieved with fewer and lower energy shock waves. BJU Int. 2009;103(1):81–4.PubMedCrossRef
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Villanyi KK, Szekely JG, Farkas LM, et al. Short-term changes in renal function after extracorporeal shock wave lithotripsy in children. J Urol. 2001;166:222–4.PubMedCrossRef
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Wadhwa P, Aron M, Bal CS, Dhanpatty B, Gupta NP. Critical prospective appraisal of renal morphology and function in children undergoing shockwave lithotripsy and percutaneous nephrolithotomy. J Endourol. 2007;21(9):961–6.PubMedCrossRef
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Reisiger K, Vardi I, Yan Y, Don S, Coplen D, Austin P, et al. Pediatric nephrolithiasis: does treatment affect renal growth? Urology. 2007;69(6):1190–4.PubMedCrossRef

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Dec 28, 2016 | Posted by in PEDIATRICS | Comments Off on Extracorporeal Shock Wave Lithotripsy: Principles of Fragmentation Techniques

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