Are there long-term effects of extracorporeal shockwave lithotripsy in paediatric patients?
Correspondence: Ahmed R. EL-Nahas, Assistant Professor of Urology, Urology and Nephrology Centre, Mansoura University, Mansoura PO: 35516, Egypt.
What's known on the subject? and What does the study add?
- Extracorporeal shockwave lithotripsy is effective for the treatment of paediatric renal stones with favourable short-term safety.
- Extracorporeal shockwave lithotripsy for treatment of paediatric renal stones is also safe for the kidney and the child on long-term follow-up.
- To evaluate the long-term effects of extracoporeal shockwave lithotripsy (SWL) for treatment of renal stones in paediatric patients.
Patients and Methods
- A database of paediatric patients who underwent SWL monotherapy for treatment of renal stones from September 1990 through to January 2009 was compiled. This study included only patients with follow-up for more than 2 years. The long-term effects of SWL were evaluated at the last follow-up with measurement of patients' arterial blood pressure, estimation of random blood sugar and urine analysis. The results of diastolic blood pressure were plotted against a standardized age reference curve. The treated kidney was examined by ultrasonography for measurement of renal length and detection of stones. The measured renal lengths were plotted against age-calculated normal renal lengths in healthy individuals.
- The study included 70 patients (44 boys (63%) and 26 girls) with mean age at the time of SWL 6.5 ± 3.6 years (range 1–14). The mean follow-up period was 5.2 ± 3.6 years (range 2.1–17.5). The mean age at last follow-up was 11.7 ± 5.3 years (range 4.4–27.5). No patients developed hypertension or diabetes. Only one treated kidney was smaller than one standard deviation of the calculated length. The cause of this was obstruction by a stone in the pelvic ureter 3 years after SWL.
- The long-term follow-up after SWL for treatment of renal stones in paediatric patients showed no effect on renal growth and no development of hypertension or diabetes.