Treatment of staghorn calculi by extracorporeal shock-wave lithotripsy in children]

To evaluate the efficacy of monotherapy with extracorporeal shock-wave lithotripsy (ESWL) for staghorn calculi in children. Material and methods: Between September 1987 and December 1998, 27 children (18 boys and 9 girls) with a mean age of 5.2 years (9 months to 147 years) were managed in our department for staghorn or pseudo-staghorn calculi. They were treated with a Lithostar Siemens-Ultra lithotriptor ith ultrasound detection. The "Puigvert method", which starts with low energy which is then gradually increased, allows satisfactory painless fragmentation, avoiding the need for general anaesthesia. RESULTS: the success rate was 70% with two sessions (37% with a single session). In one case, lithotripsy was not indicated and percutaneous nephrolithotomy was necessary. Two cystine stones ina girl (probably longstanding stones) could not be fragmented and open surgery was required. The other five systine staghorn calculi ere treated successfully. Ureteral catheterization was not required and only one double J stent was placed preventively in a girl with a solitary kidney. No major complication was detected. CONCLUSION: ESWL with the Siemens-Ultra lithotriptor is a safe and effective first-line method for the treatment of staghron calculi in children.