Comparison of efficacy and safety of ESWL in paediatric and adolescent versus adult urolithiasis: A single center 5-year experience from a tertiary care hospital
Objective: To retrospectively compare the efficacy and safety of extra-corporeal shock wave lithotripsy (ESWL) for renal/upper ureteric calculi in pediatric/adolescents (group 1) vs adults(group 2).
Subjects and methods: Medical records of 948 patients who underwent ESWL for renal/upper ureteric calculi at a tertiary care center in North India from January 2012 to December 2017 (five years). The Dornier compact alpha-K1025163 (Dornier Med Tech) equipment was used for ESWL. We evaluated the stonefree rates, the number of ESWL sessions, use of ancillary procedures and complications between the two groups.
Results: A total of 110 patients were in group 1 and 838 patients were in group 2. The mean stone size in group 1 patients was 1.20 ± 1.18 cm2 while in group 2 it was 1.49 ± 0.37 cm2. The stone clearance rate was 85/110 (77%) for the group 1 and 545/838(65%) for group 2 patients. In group 1, a second session was required in 28/110 (25.4%) patients and the third session was required in 5/110 (4.5%) patients while in the adult group two sessions were required in 175 (20.8%) and three sessions were required in 24 (19.2%) patients. The overall complication rate in group 1 was 15/110 (13.63%) and in the group, II was 105/838 (12.5%). No statistical difference was found between post-ESWL complications and use of ancillary procedures (DJ stenting/PCNL) (p = 0.067).
Conclusion: In renal/upper ureteric calculi ESWL has got better efficacy, comparable safety and requires equivalent ancillary procedures in children and adolescents compared to adults.