Purpose: We aimed to evaluate the effects of preoperative urinary catheterization in nephrolithiasis treatment with extracorporeal shock wave lithotripsy (SWL). Methods: Patients admitted to the Department of Pediatric Surgery for renal stones between June 2012 and June 2014 were evaluated retrospectively. Patients were divided into 2 groups based on JJ stent placements. Group 1 did not receive JJ stents, while group 2 did. The recorded demographic data for each group included age, gender, stone size, location, sessions, and complications. The Elmed Complit ESWL system was used with 11-13 kV, and 1,000-1,200 shots in patients 2-4 years of age, and 11-14 kV, and 1,000-1,500 shots for patients over 4 years. Results: In group 1, 18 sessions of SWL were performed on 8 female and 2 male children with a mean age of 4.5 (range 2-12) years and stone diameter of 9 (range 7-15) mm. The locations of the renal stones were in the upper pole in 1 patient, 7 in the lower pole, and 2 in the pelvis renalis. Postoperatively, 1 patient had hematuria, 2 had dysuria, and one had a stone in the external urethral meatus. Eighty percent of patients were stone free; there were no fragmentations in 2 patients, and 1 patient discontinued treatment. In group 2, 15 SWL sessions were performed on 5 female and 5 male children aged 4 (range 3-5) and the stone diameter was 9 (range 7-16) mm. The locations of the renal stones were in the upper pole in 6 patients, in the lower pole in 3 patients, and in the ureteropelvic junction in one patient. JJ stents were placed in all patients preoperatively. Postoperatively, 3 patients had hematuria and one had dysuria. At the end of the study, all of the patients were stone free. Statistically, there were no differences in age, gender, stone size, location, and the number of sessions. Conclusions: Our results indicate that SWL without preoperative ureteral stenting is an effective and safe procedure that can be carried out in the pediatric population. Preoperative JJ stenting is unnecessary in patients, especially in those with smaller stone diameters.

Keywords:
Renal stones, Pediatrics, Extracorporeal shock wave lithotripsy, Stents
1.
D'Addessi A, Bongiovanni L, Racioppi M, Sacco E, Bassi P: Is extracorporeal shock wave lithotripsy in pediatrics a safe procedure? J Pediatr Surg 2008;43:591-596.
2.
Durner L, Bach C, El Howairis Mel F, Hakenberg OW, Buchholz N: Current trends in urolithiasis treatment in various European health systems. Urol Int 2016;96:125-131.
3.
Turna B, Tekin A, Yağmur İ, Nazlı O: Extracorporeal shock wave lithotripsy in infants less than 12-month old. Urolithiasis 2016;44:435-440.
4.
Fayad A, El-Sheikh MG, Abdelmohsen M, Abdelraouf H: Evaluation of renal function in children undergoing extracorporeal shock wave lithotripsy. J Urol 2010;184:1111-1114.
5.
López M, Hoppe B: History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol 2010;25:49-59.
6.
Elmacı AM, Ece A, Akın F: Clinical characteristics and metabolic abnormalities in preschool-age children with urolithiasis in Southeast Anatolia. J Pediatr Urol 2014;10:495-499.
7.
Elmacı AM, Ece A, Akın F: Pediatric urolithiasis: metabolic risk factors and follow-up results in a Turkish region with endemic stone disease. Urolithiasis 2014;42:421-426.
8.
Göktaş C, Akça O, Horuz R, Gökhan O, Albayrak S, Sarica K: Does child's age affect interval to stone-free status after SWL? A critical analysis. Urology 2012;79:1138-1142.
9.
Mittal V, Srivastava A, Kappor R, Ansari MS, Patidar N, Arora S, Kumar M, Kudchadkar S, Raj A: Standardized grading of shock wave lithotripsy complications with modified Clavien system. Urol Int 2016;97:273-278.
10.
Middela S, Papadopoulos G, Srirangam S, Rao P: Extracorporeal shock wave lithotripsy for ureteral stones: do decompression tubes matter? Urology 2010;76:821-815.
11.
Mustafa M, Ali-El-Dein B: Stenting in extracorporeal shockwave lithotripsy; may enhance the passage of the fragments! J Pak Med Assoc 2009;59:141-143.
12.
Lucio J 2nd, Korkes F, Lopes-Neto AC, Silva EG, Mattos MH, Pompeo AC: Steinstrasse predictive factors and outcomes after extracorporeal shockwave lithotripsy. Int Braz J Urol 2011;37:477-482.
13.
Al-Busaidy SS, Prem AR, Medhat M: Pediatric staghorn calculi: the role of extracorporeal shock wave lithotripsy monotherapy with special reference to ureteral stenting. J Urol 2003;169:629-633.
14.
Telli O, Gokce MI, Ozturk E, Suer E, Mermerkaya M, Afandiyev F, Ozcan C, Guclu AG, Soygur T, Burgu B: What is the best option for 10-20mm renal pelvic stones undergoing ESWL in the pediatric population: stenting, alpha blockers or conservative follow-up? J Pediatr Surg 2015;50:1532-1534.
15.
Onal B, Citgez S, Tansu N, Demirdag C, Dogan C, Gonul B, Demirkesen O, Obek C, Erozenci A: Predictive factors and management of steinstrasse after shock wave lithotripsy in pediatric urolithiasis - a multivariate analysis study. Urology 2012;80:1127-1131.
16.
Enmar IH, Morsi HA, Elsheemy MS, Aboulela W, Eissa MA: Effect of size and site on the outcome of extracorporeal shock wave lithotripsy of proximal urinary stones in children. J Pediatr Urol 2013;9:323-327.
17.
Ryan PC, Lennon GM, McLean PA, Fitzpatrick JM: The effects of acute and chronic JJ stent placement on upper urinary tract motility and calculus transit. Br J Urol 1994;74:434-439.
18.
Chandhoke PS, Barqawi AZ, Wernecke C, Chee-Awai RA: A randomized outcomes trial of ureteral stents for extracorporeal shock wave lithotripsy of solitary kidney or proximal ureteral stones. J Urol 2002;167:1981-1983.
19.
Shen P, Jiang M, Yang J, Li X, Li Y, Wei W, Dai Y, Zeng H, Wang J: Use of ureteral stent in extracorporeal shock wave lithotripsy for upper urinary calculi: a systematic review and meta-analysis. J Urol 2011;186:1328-1335.
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2016
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