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Extracorporeal shock wave lithotripsy for cystine urolithiasis in children: Outcome and complications

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Abstract

The Siemens Lithostar Litotriptor was used to treat 6 children withcystine nephrolithiasis, previously treated by open surgery. Fivechildren had renal calculi (3 multiple caliceal, 2 pelvis) and one hadureteral calculus. Stone size ranged from 0.2–2.5 cm in diameter,and stone burden was from 0.24 to 10.81 cm3 per kidney. Fromone to 4 ESWL sessions per unit were applied, with a total of 1,800 to12,000 shock waves. The stone free rate at 3 months was 50%. Acomplete elimination was obtained with cystine stones in renal pelvisand ureter, however, up to 4 ESWL treatments failed in caliceal stones.Rather location of cystine calculi than previous surgery was associatedwith ESWL success rate. Two patients with positive urine cultures weresuccessfully treated with appropriate antibiotics before ESWL wasattempted. Perirenal hematoma was major complication demonstrated byradionuclide scintigraphy in one patient, and resolved spontaneously by3 months. In the combined treatment of cystine urolithiasis in childrenESWL, as auxillary procedure, was safe and effective in pelvis stone butfailed in caliceal stones. Medical dissolution for retained fragmentswas found effective.

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Authors and Affiliations

  1. Clinic for Pediatric Surgery, Clinical Center, Nis, Yugoslavia

    Andjelka Slavković

  2. Institute of Radiology, Clinical Center, Nis, Yugoslavia

    Miladin Radovanović & Zlatko Širić

  3. Department of Nuclear Medicine, Clinical Center, Nis, Yugoslavia

    Marina Vlajković

  4. Institute of Nephrology and Hemodialysis, Clinical Center, Nis, Yugoslavia

    Vladisav Stefanović

Authors
  1. Andjelka Slavković
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  2. Miladin Radovanović
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  3. Zlatko Širić
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  4. Marina Vlajković
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  5. Vladisav Stefanović
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Correspondence to Vladisav Stefanović.

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Slavković, A., Radovanović, M., Širić, Z. et al. Extracorporeal shock wave lithotripsy for cystine urolithiasis in children: Outcome and complications. Int Urol Nephrol 34, 457–461 (2002). https://doi.org/10.1023/A:1025694230131

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  • DOI: https://doi.org/10.1023/A:1025694230131

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