Use of mobile extracorporeal shock wave lithotripter: Experience in a pediatric institution

Abstract 

Objectives

To present our results of the past 3 years using a mobile lithotripter in a pediatric institution. The low incidence of pediatric urinary calculi, along with the high cost of lithotripsy units, has limited the use of extracorporeal shock wave lithotripsy in pediatric institutions.

Methods

A retrospective cohort study was performed of all children who had undergone extracorporeal shock wave lithotripsy at two institutions from 1999 to 2003. All patients were treated with a Dornier Compact Delta mobile lithotriptor with a universal urologic table.

Results

A total of 88 patients (38 males and 50 females) underwent a total of 119 outpatient treatments. The mean patient age was 12 years, and the mean follow-up was 20 months. The mean stone size was 6 mm. An average of 1600 shocks per procedure was performed. Overall, 68% were stone free after one treatment, and 74% were stone free after one or two treatments. Of the patients with a solitary stone, 72% were stone free after one treatment and 78% were after one or two treatments. Fifteen patients had multiple stones treated simultaneously on the same side. Of these, 47% were stone free after one treatment and 53% after one or two treatments. Two patients subsequently required ureteroscopy and laser lithotripsy for obstructing ureteral calculi.

Conclusions

The results of our study have shown that the new-generation mobile lithotripter is safe and effective in treating pediatric nephrolithiasis. The success rate was greater for solitary stones than for multiple stones treated at the same setting. Additional endoscopic procedures can be performed simultaneously on the same table.