Introduction. Urolithiasis (ICD) in children is an urgent problem of pediatric urology. In pediatric practice, the priority in surgical treatment belongs to the methods that ensure maximum effectiveness with minimal invasiveness. Remote shock wave lithotripsy (RVL) has been one of the main methods of surgical treatment of ICD for decades. The Storz Medical Modulith SLK lithotripter is used in global pediatric practice only in a limited number of clinics, which determines the relevance of studying the experience of its use in children.
The aim is to evaluate the efficacy and safety of DVL on the Storz Medical Modulith SLK device in children with ICD.
Material and methods. The prospective study included 46 patients (1-17 years old, average age – 10 years ± 4.2 years) with 55 concretions ranging in size from 6 to 42 mm (average – 13.7±3 mm) in the largest dimension. The average density of concretions according to native computed tomography was 1269±412 HU (600; 2500 HU). 64 DUVL sessions were conducted. The effectiveness was evaluated after 1 and 3 months according to ultrasound and computed tomography. Complications were graded using the Clavien–Dindo classification.
Results. Stone-free (SFR) status was achieved in 43 out of 46 patients, which was 93.5%. After the first session, 35 (76%) had it. The average number of sessions per patient is 1.25. Grade II complications – 3.1%, grade IIIb – 3.1%. The effectiveness depended on the size of the concretion, the density and localization of the concretion were not significant predictors of achieving SFR. The overall effectiveness of the IWRM was 100% for concretions
<20 mm in size and 62.5% for concretions >20 mm in size.
Conclusion. In recent years, the active development of endoscopic technologies, in particular percutaneous nephrolithotripsy, transurethral nephrolithotripsy and transurethral ureterolithotripsy, has led to a decrease in the frequency of use of DVL in pediatric practice. However, the results of the study indicate a possible underestimation of the clinical potential of DVL: the achieved SFR (93.5%) is comparable to the best international results and is fully consistent with the data of independent publications. The analysis, which became the first study in Russia on the use of Storz Medical Modulith SLK lithotripter in children, confirms the high efficacy and safety of the method.