Extracorporeal shock wave lithotripsy in prepubertal children: 22-year experience at a single institution with a single lithotriptor.

Purpose: The sophistication of percutaneous nephrolithotomy and ureteroscopy challenges the efficacy of ESWL® for urolithiasis in prepubertal patients. We evaluated our long-term experience with ESWL in these patients and determined its efficiency.Materials and Methods: We retrospectively reviewed the charts of all prepubertal patients who underwent ESWL. We evaluated the need for tubing, the 3-month stone-free rate, the need for additional ESWL, and the effect of stone size and location, and cystinuria on the 3-month stone-free rate.Results: Between 1986 and 2008, 119 males and 97 females with a mean age of 6.6 years who had urolithiasis underwent ESWL using the Dornier® HM3 lithotriptor. We treated 157 children with renal calculi with an average ± SD diameter of 14.9 ± 8.9 mm, of whom 66 (42%) required a tube in the urinary system. The 3-month stone-free rate was 80% and 31 patients (19.7%) needed an additional procedure. Stone location did not affect the stone-free rate but stone size did. We treated 5...