[Extracorporeal shock-wave lithotripsy in infants. Study of its repercussions on the renal parenchyma]. / La lithotritie extra-corporelle par ondes de choc chez le nourrisson. Etude de son retentissement sur le parenchyme rénal.

ABSTRACT

PURPOSE: To evaluate the efficacy of extracorporeal shock-wave lithotripsy (ESWL) in infants (less than 2-years-old) and study the potential long-term renal parenchymal damage by 99 m Tc DMSA renal scan. MATERIALS AND METHODS: Between November 1993 and February 1998, 12 children underwent ESWL treatment for kidney and ureter urolithiasis with a Sonolith 3,000 lithotriptor (Technomed-Corp). All children were less than 2-years-old. Evaluation of treatment and its consequences was based on clinical examination, conventional imaging (plain abdominal radiography excretory urogram) and a DMSA renal scan performed 24 hours before ESWL and at least 6 months after treatment. RESULTS: Treatment was successful in 84.6% of cases, by achieving stone-free status after one session and 100% after 2 sessions. Long-term follow-up (one month to four years) did not reveal any blood pressure or renal function changes. No acquired parenchymal scar was identified. On DMSA renal scan. CONCLUSIONS: The efficacy of ESWL in treating infant urolithiasis is clearly established. Renal parenchymal damage associated with ESWL did not appear in this study, but long-term follow-up mandatory (blood pressure) and each infant should have a DMSA renal scan before and after ESWL to confirm these preliminary results on a larger series.