Abstract
The aim of the study to compare low and intermediate shock wave frequency rates in terms of success and complications for treating pediatric kidney stones. This retrospective study was performed on 58 consecutive pediatric patients (24 girls, 34 boys) who underwent shock wave lithotripsy (SWL) for kidney stones with an electrohydraulic lithotripter between April 2014 and March 2016. In the first year, all children underwent SWL with a frequency of 90 SWs/min as an intermediate frequency (Group 90), and in the second year all children were treated by SWL using 60 SWs/min as a low frequency (Group 60). The mean age of the patients was 5.87 ± 4.5 years. There were no significant differences in age, gender, stone characteristics and SWL energy level between the groups. Stone-free status was achieved in 14, 6 and 4 children in group 60; and in 10, 6 and 4 children in group 90 after one, two and three sessions, respectively. The stone-free rates were 80 and 74.1% after SWL and 90 and 88.9% after additional treatment in groups 60 and 90, respectively. The total median shock pulses were 2000 and 3600 in groups 60 and 90, respectively (p = 0.115). Efficiency quotients were 51.93 and 44.47 in groups 60 and 90, respectively. The mean total anesthesia times and complication rates did not differ between the groups. The low and intermediate frequency of SWL provided similar stone clearance in pediatric renal stones with similar anesthesia times. However, low SWL tended to need fewer shock pulses (2000/3600) for stone clearance, but the trend was not significant.
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Tekgül S, Doğan HS, Erdem E, Hoebeke P, Kocvara R, Nijman JM, Radmayr C, Sılay MS, Stein R, Undre S (2015) Urınary stone disease. EAU Guidel Paediatr Urol March:51–58
Dogan HS, Altan M, Citamak B, Bozaci AC, Karabulut E, Tekgul S (2015) A new nomogram for prediction of outcome of pediatric shock-wave lithotripsy. J Pediatr Urol 11(2):1–6. doi:10.1016/j.jpurol.2015.01.004
Jeong US, Lee S, Kang J, Han DH, Park KH, Baek M (2013) Factors affecting the outcome of extracorporeal shock wave lithotripsy for unilateral urinary stones in children: a 17-year single-institute experience. Korean J Urol 54(7):460–466. doi:10.4111/kju.2013.54.7.460
Onal B, Tansu N, Demirkesen O, Yalcin V, Huang L, Nguyen HT, Cilento BG, Erozenci A (2013) Nomogram and scoring system for predicting stone-free status after extracorporeal shock wave lithotripsy in children with urolithiasis. BJU Int 111(2):344–352. doi:10.1111/j.1464-410X.2012.11281.x
Lingeman JE, McAteer JA, Gnessin E, Evan AP (2009) Shock wave lithotripsy: advances in technology and technique. Nat Rev Urol 6(12):660–670. doi:10.1038/nrurol.2009.216 (Review)
Li WM, Wu WJ, Chou YH, Liu CC, Wang CJ, Huang CH, Lee YC (2007) Clinical predictors of stone fragmentation using slow-rate shock wave lithotripsy. Urol Int 79(2):124–128
Kang DH, Cho KS, Ham WS, Lee H, Kwon JK, Choi YD, Lee JY (2016) Comparison of high, intermediate, and low frequency shock wave lithotripsy for urinary tract stone disease: systematic review and network meta-analysis. PLoS One 11(7):e0158661. doi:10.1371/journal.pone.0158661 (eCollection 2016)
Salem HK, Fathy H, Elfayoumy H, Aly H, Ghonium A, Mohsen MA, Hegazy Ael R (2014) Slow vs rapid delivery rate shock wave lithotripsy for pediatric renal urolithiasis: a prospective randomized study. J Urol 191(5):1370–1374. doi:10.1016/j.juro.2013.11.028
Ather MH, Memon A (2000) Therapeutic efficacy of Dornier MPL 9000 for prevesical calculi as judged by efficiency quotient. J Endourol 14(7):551–553
Paterson RF, Lifshitz DA, Lingeman JE, Evan AP, Connors BA, Fineberg NS, Williams JC Jr, McAteer JA (2002) Stone fragmentation during shock wave lithotripsy is improved by slowing the shock wave rate: studies with a new animal model. J Urol 168(5):2211–2215
Greenstein A, Matzkin H (1999) Does the rate of extracorporeal shock wave delivery affect stone fragmentation? Urology 54(3):430–432
Evan AP, McAteer JA, Connors BA, Blomgren PM, Lingeman JE (2007) Renal injury during shock wave lithotripsy is significantly reduced by slowing the rate of shock wave delivery. BJU Int 100(3):624–627 (discussion 627-8)
Pishchalnikov YA, McAteer JA, Williams JC Jr, Pishchalnikova IV, Vonderhaar RJ (2006) Why stones break better at slow shockwave rates than at fast rates: in vitro study with a research electrohydraulic lithotripter. J Endourol 20(8):537–541
Pishchalnikov YA, McAteer JA, Williams JC Jr (2008) Effect of firing rate on the performance of shock wave lithotriptors. BJU Int 102(11):1681–1686
Duryea AP, Roberts WW, Cain CA, Tamaddoni HA, Hall TL (2014) Acoustic bubble removal to enhance SWL efficacy at high shock rate: an in vitro study. J Endourol 28(1):90–95. doi:10.1089/end.2013.0313
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Kaygısız, O., Kılıçarslan, H., Mert, A. et al. Comparison of intermediate- and low-frequency shock wave lithotripsy for pediatric kidney stones. Urolithiasis 46, 391–395 (2018). https://doi.org/10.1007/s00240-017-1002-1
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DOI: https://doi.org/10.1007/s00240-017-1002-1