International Urology and Nephrology

, Volume 46, Issue 11, pp 2095–2101 | Cite as

Extracorporeal shockwave lithotripsy under sedoanalgesia for treatment of kidney stones in infants: a single-center experience with 102 cases

  • Senol AdanurEmail author
  • Tevfik Ziypak
  • Ali Haydar Yılmaz
  • Huseyin Kocakgol
  • Mehmet Aksoy
  • Turgut Yapanoglu
  • Ozkan Polat
  • Yılmaz Aksoy
Urology - Original Paper



We present the efficacy of shockwave lithotripsy (SWL) therapy administered with sedoanalgesia in infants with kidney stones.

Materials and methods

We enrolled 102 patients aged 5–24 months who had kidney stones and received SWL therapy under sedoanalgesia using a Siemens Lithostar Modularis device. Patient and stone characteristics, therapy parameters, pain score, complications, discharge time, and follow-ups were registered and evaluated. Pain score was assessed using a Neonatal Infant Pain Score (NIPS). Postanesthetic discharge scoring system (PADSS) was used for the assessments of postprocedural discharge procedure.


Mean age of the patients was 17.2 ± 6.3 months (5–24 months). Mean stone size was 7.9 ± 3.3 mm (5–23 mm). The most common concomitant metabolic disorders were hypercalciuria and hypocitraturia. The stone-free rates of the infants were 70.6, 87.3, and 99.1 % after the first, second, and third sessions of SWL therapy, respectively. The mean NIPS scores procedure during, and at 1 h after SWL procedure were determined as 0.24 ± 0.45 and 0.34 ± 0.47, respectively. There was no statistically significant difference between two pain score values (P = 0.114). The mean discharge time of patients after the SWL procedure were 108.6 ± 27.9 min. Forty-two patients (41.1 %) were followed up. The follow-up period varied between 8 and 48 months (mean 19.5 months); none of those patients showed evidence of diabetes mellitus, hypertension, or renal function impairment.


SWL therapy under sedoanalgesia is a safe and efficient treatment modality that can be administered with low complication rates and high stone-free rates in the treatment of renal stones in infants.


İnfant Renal stones Lithotripsy 


Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Tellaloglu S, Ander H (1984) Stones in children. Turk J Pediatr 26:51–60PubMedGoogle Scholar
  2. 2.
    Sharma AP, Filler G (2010) Epidemiology of pediatric urolithiasis. Indian J Urol 26(4):516–522PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Sarica K (2006) Pediatric urolithiasis: etiology, specific pathogenesis and medical treatment. Urol Res 34(2):96–101PubMedCrossRefGoogle Scholar
  4. 4.
    Ramakrishnan PA, Medhat M, Al-Bulushi YH et al (2007) Extracorporeal shockwave lithotripsy in infants. Can J Urol 14(5):3684–3691PubMedGoogle Scholar
  5. 5.
    Lottmann HB, Archambaud F, Traxer O et al (2000) The efficacy and parenchymal consequences of extracorporeal shock wave lithotripsy in infants. BJU Int 85(3):311–315PubMedCrossRefGoogle Scholar
  6. 6.
    Shukla AR, Hoover DL, Homsy YL et al (2001) Urolithiasis in the low birth weight infant: the role and efficacy of extracorporeal shock wave lithotripsy. J Urol 165:2320–2323PubMedCrossRefGoogle Scholar
  7. 7.
    Aldridge RD, Aldridge RC, Aldridge LM (2006) Anesthesia for pediatric lithotripsy. Paediatr Anaesth 16(3):236–241PubMedCrossRefGoogle Scholar
  8. 8.
    Lawrence J, Alcock D, McGrath P et al (1993) The development of a tool to assess neonatal pain. Neonatal Netw 12(6):59–66PubMedGoogle Scholar
  9. 9.
    Chung F (1995) Recovery pattern and home-readiness after ambulatory surgery. Anesth Analg 80(5):896–902PubMedGoogle Scholar
  10. 10.
    Yoshida O, Okada Y (1990) Epidemiology of urolithiasis in Japan: a chronological and geographical study. Urol Int 45(2):104–111PubMedCrossRefGoogle Scholar
  11. 11.
    Rizvi SA, Naqvi SA, Hussain Z et al (2002) Pediatric urolithiasis: developing nation perspectives. J Urol 168(4 Pt 1):1522–1525PubMedCrossRefGoogle Scholar
  12. 12.
    Mishriki SF, Wills MI, Mukherjee A et al (1992) Extracorporeal shock wave lithotripsy for renal calculi in children. Br J Urol 69(3):303–305PubMedCrossRefGoogle Scholar
  13. 13.
    Frick J, Köhle R, Kunit G (1988) Experience with extracorporeal shock wave lithotripsy in children. Eur Urol 14(3):181–183PubMedGoogle Scholar
  14. 14.
    Tan AH, Al-Omar M, Watterson JD et al (2004) Results of shockwave lithotripsy for pediatric urolithiasis. J Endourol 18(6):527–530PubMedCrossRefGoogle Scholar
  15. 15.
    Schultz-Lampel D, Lampel A (2001) The surgical management of stones in children. BJU Int 87(8):732–740PubMedCrossRefGoogle Scholar
  16. 16.
    Muslumanoglu AY, Tefekli A, Sarilar O et al (2003) Extracorporeal shock wave lithotripsy as first line treatment alternative for urinary tract stones in children: a large scale retrospective analysis. J Urol 170:2405–2408PubMedCrossRefGoogle Scholar
  17. 17.
    Wadhwa P, Aron M, Seth A et al (2007) Pediatric shockwave lithotripsy: size matters! J Endourol 21(2):141–144PubMedCrossRefGoogle Scholar
  18. 18.
    McLorie GA, Pugach J, Pode D et al (2003) Safety and efficacy of extracorporeal shock wave lithotripsy in infants. Can J Urol 10(6):2051–2055PubMedGoogle Scholar
  19. 19.
    Vandeursen H, Devos P, Baert L (1991) Electromagnetic extracorporeal shock wave lithotripsy in children. J Urol 145(6):1229–1231PubMedGoogle Scholar
  20. 20.
    Gofrit ON, Pode D, Meretyk S et al (2001) Is the pediatric ureter as efficient as the adult ureter in transporting fragments following extracorporeal shock wave lithotripsy for renal calculi larger than 10 mm.? J Urol 166(5):1862–1864PubMedCrossRefGoogle Scholar
  21. 21.
    Aksoy Y, Ziypak T, Yapanoglu T (2009) Comparison of the effectiveness and safety of MPL 9000 and Lithostar Modularis shockwave lithotriptors: treatment results of 263 children. Urol Res 37(2):111–116PubMedCrossRefGoogle Scholar
  22. 22.
    Bierkens AF, Hendrikx AJ, de Kort VJ et al (1992) Efficacy of second generation lithotriptors: a multicenter comparative study of 2,206 extracorporeal shock wave lithotripsy treatments with the Siemens Lithostar, Dornier HM4, Wolf Piezolith 2300, Direx Tripter X-1 and breakstone lithotriptors. J Urol 148:1052–1056PubMedGoogle Scholar
  23. 23.
    Ozbey I, Aksoy Y, Ziypak T et al (2007) Shock wave lithotripsy is effective and safe for distal ureteral calculi in children. Urol Res 35:237–241PubMedCrossRefGoogle Scholar
  24. 24.
    Landau EH, Gofrit ON, Shapiro A et al (2001) Extracorporeal shock wave lithotripsy is highly effective for ureteral calculi in children. J Urol 165:2316–2319PubMedCrossRefGoogle Scholar
  25. 25.
    Traxer O, Lottmann H, Archambaud F et al (1999) Extracorporeal lithotripsy in children. Study of its efficacy and evaluation of renal parenchymal damage by DMSA-Tc 99 m scintigraphy: a series of 39 children. Arch Pediatr 6(3):251–258PubMedCrossRefGoogle Scholar
  26. 26.
    Claro Jde A, Denardi F, Ferreira U et al (1994) Effects of extracorporeal shockwave lithotripsy on renal growth and function: an animal model. J Endourol 8(3):191–194PubMedCrossRefGoogle Scholar
  27. 27.
    Resorlu B, Unsal A, Tepeler A et al (2012) Comparison of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy in children with moderate-size kidney stones: results of multi-institutional analysis. Urology 80(3):519–523PubMedCrossRefGoogle Scholar
  28. 28.
    Smaldone MC, Cannon GM Jr, Wu HY et al (2007) Is ureteroscopy first line treatment for pediatric stone disease? J Urol 178(5):2128–2131PubMedCrossRefGoogle Scholar
  29. 29.
    Unsal A, Resorlu B (2011) Retrograde intrarenal surgery in infants and preschool-age children. J Pediatr Surg 46(11):2195–2199PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Senol Adanur
    • 1
    Email author
  • Tevfik Ziypak
    • 1
  • Ali Haydar Yılmaz
    • 1
  • Huseyin Kocakgol
    • 1
  • Mehmet Aksoy
    • 2
  • Turgut Yapanoglu
    • 1
  • Ozkan Polat
    • 1
  • Yılmaz Aksoy
    • 1
  1. 1.Department of Urology, School of MedicineAtaturk UniversityErzurumTurkey
  2. 2.Department of Anaesthesiology and Reanimation, School of MedicineAtaturk UniversityErzurumTurkey

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