Extracorporeal Shock Wave Lithotripsy (Eswl) in Infant Urolithiasis Management
Purpose We evaluated the efficiency of ESWL in the treatment of urinary calculi in children under 2 years old. Material and Methods Forty five renal units of forty patients (29 boys, 11 girls, median age: 10 months range: 10 days- 24 months), were treated with ESWL for urolithiasis (median age: 13 months range: 3-24 months) under sedation. Stones were in lower calyx in 14, mid calyx in 15, upper calyx in 6, the renal pelvis,in 21, the proximal ureter in one patient. The mean stone burden was 76,8±55 mm 2 (16 - 247 mm 2 ).Efficiency of treatment is calculated with Efficiency quotient (EQ: stone-free% X 100/ (100% + %re-treatment rate+% auxiliary procedures) formula. Results 59 ESWL sessions (mean:1,33±0,67,range1-4) were performed. Stone free (SF) rate was 82,2% (37/45), clinical insignificant residual fragment (CIRF) rate was 17,7% and ESWL failure was not observed in any patients. Mean EQ was 0,64. There was no significant statistical association between the locations, size and the number of successfully treated calculi (table). SF CIRF Total  Renal Units (n) 37 8 45  Median Age (months) 11 9 10  Mean Calculus Size (mm2) 77,76 72,62 76,8  Mean SWL Session 1.29 1.37 1.33  Mean Shock Number 1400 1375 1382  Mean Maximum Energy 1.59 1.4 1.53  Mean Average Energy 1 0,97 0,99 Calculus Localization (%) EQ Pelvis 85,7% 14,28% 0.69 21 Upper pole 83,3% 16,7% 0.63 6 Middle pole 80% 20% 0,50 15 Lower pole 78,6% 21,4% 0,58 14 Proximal ureter 100% 1 1 Conclusions ESWL is a safe and a very efficient treatment method in infant age group.All of the patients presented with a complete or partial response. Complete stone clearance was possible 82,2%. There was no marked difference in different locations in this age group.