Shock Wave Lithotripsy in Pediatric Stone Disease: A 15-Year Single-Center Experience with 2 Types of Lithotripters

Abstract

<b><i>Introduction and Objectives:</i></b> We report our experience with pediatric shock wave lithotripsy (SWL) using two types of lithotripters: Dornier HM3 (HM3) and Dornier Lithotripter SII (DLS). <b><i>Study Design:</i></b> We retrospectively reviewed the charts of children who underwent SWL between 2002 and 2016. Patients were divided into two groups based on the type of the lithotripter: during 2002–2009, we used the electrohydraulic HM3 lithotripter which was replaced in 2009 with the DLS electromagnetic lithotripter. Clinical and perioperative parameters were compared. <b><i>Results:</i></b> Our cohort included 107 children who underwent SWL. Average age was 11.5 ± 5.1 years. Average stone size was 10.6 ± 4.9 mm. HM3 was used in 38% of children and DLS2 in 62% (<i>n</i> = 41 and 66, respectively). There were no significant differences in age, gender, stone size, or location between the groups. The total SFR did not differ statistically between HM3 and DLS (83% vs. 74%, <i>p</i> = 0.35). SFR after one SWL was higher with the HM3 (78% vs. 62%, <i>p</i> = 0.093). Re-treatment rate was 22% and 17% (HM3 vs. DLS, <i>p</i> = 0.61). Complication rates were low, with renal colic being the most common (HM3 10%, DLS 20%, NS). <b><i>Conclusions:</i></b> SWL in the pediatric population using the DLS showed good results with low complication rates that are equivalent to the gold standard HM3.