Shockwave lithotripsy and endourological stone treatment in children

Abstract

Urolithiasis in children is a rare disease in developed countries. Due to the particular anatomical conditions of the infant body, indications and results of the well-known treatment modalities, such as shockwave lithotripsy (SWL), ureteroscopy and PCNL, have to be determined. Experience in active stone treatment in children is very rare and only a limited number of papers are available. SWL can be performed only if focus size and treatment facilities are adapted to the size of the child. Miniaturization of ureteroscopes allows primary access to the infant upper urinary tract. Results, complications and morbidity of the treatment are similar to the results in adults. The main prerequisite for the primary endoscopic approach is the experience of the surgeon. PCNL should be performed as Mini-Perc. Percutaneous procedures show equal results and morbidity compared to the treatment of adults, in experienced hands. As two-thirds of infant stone patients have an underlying metabolic disorder, close cooperation of adult and pediatric urologists, nephrologists and radiologists is necessary in order to achieve good results in the treatment of infant stones.