Does Previous Open Stone Surgery Affect the Outcome of Shock Wave Lithotripsy Treatment in Children?

Abstract

<b><i>Introduction:</i></b> The aim of the study was to evaluate the efficiency of shock wave lithotripsy (SWL) in children who previously underwent ipsilateral open renal stone surgery (ORSS). <b><i>Methods:</i></b> A total of 315 renal units (RUs) with renal stones underwent SWL treatment in our department over a period of 18 years. A total of 274 RUs (87%) with no history of ORSS were categorized as group 1 and 41 RUs (13%) with a history of ORSS were categorized as group 2. The characteristics of the patients and renal stones, as well as the treatment modalities, were reviewed retrospectively, and the results were compared in terms of the rates of stone-free patients and complications. <b><i>Results:</i></b> The stone-free rates were statistically lower in patients with an existing history of ORSS (<i>p</i> = 0.002), especially for stones located at the lower calyx (<i>p</i> = 0.006). However, there were no differences between groups in the rate of complications (<i>p</i> = 0.75). History of ipsilateral ORSS, age, and stone burden were independent risk factors that predicted a stone-free status in the regression analysis (<i>p</i> = 0.016, <i>p</i> = 0.045, and <i>p</i> = 0.001, respectively). <b><i>Conclusion:</i></b> The overall stone-free rate after SWL was found to be significantly lower in children with a history of ORSS than in those without, and this finding was significantly prominent for lower calyx stones. In spite of the possible difficulties in achieving surgical access due to anatomical changes in retrograde intrarenal surgery or mini-/micro-percutaneous nephrolithotomy, we believe that these techniques might be good alternatives for SWL in future cases.