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clinmed/1999120008v1 (December 13, 1999)
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Extracorporeal Shockwave Lithotripsy in Children

Vincent C. Onuora, Mohammed Al Turki, Abdelmoniem Koko, Ahmed Meabed, and Nasser Al Jawini

Department of Urology, Riyadh Medical Complex, Riyadh.Saudi Arabia.

Abstract. Between 1993 and 1998, 67 children with stones in the urinary tract were treated by ESWL in our department. There were 38 boys and 29 girls and their ages ranged from 5-16 years (mean 12.9). The majority of the children presented with pain (79 %) or haematuria (13.4 %). Diagnosis was established by the use of sonography and intravenous urography (IVU). Stone disease was associated with horseshoe kidney, posterior urethral valve, pelvi-ureteric junction obstruction and external meatal stenosis in one child each. There were 56 renal (37 pelvic, 16 calyceal and 3 staghorn); eleven ureteric and 3 bladder stones. The stone sizes ranged from 4 mm to 40 mm (mean 16) in the largest diameter. ESWL was done as an outpatient procedure in 20 children (30 %), and the rest required admission to the hospital. Double J stents were placed in 15 children with stones larger than 20 mm. General anaesthesia was used in 19 children, usually those below the age of twelve. The others received intravenous pethidine for sedation and analgesia. The mean number of shocks delivered was 3000 and the generator voltage ranged from 16 to 19 kV. Most of the patients required only one ESWL session (mean 1.7). The overall stone free rate was 82 % and this was achieved during a mean period of twelve weeks. Four children developed febrile urinary tract infection and 2 steinstrasse. Follow-up was poor. Our results suggest that at short term, ESWL was an effective and safe treatment modality for urinary lithiasis in children. Key words: Extracorporeal shockwave lithotripsy; children; Saudi Arabia