[Remote lithotripsy with the URAT-P apparatus in treating urolithiasis in children].Urol Nefrol (Mosk). 1990 May-JunUN
The Soviet-made device "URAT-P" for remote lithotripsy was used for the treatment of urolithiasis in children aged from 22 months to 14 years who suffered from various clinical patterns of urolithiasis with solitary or dendritic calculi. Out of 64 treated persons, 21 children had undergone 1-2 surgeries for the disease. The majority of them had pains and frequent aggravations of pyelonephritis. Excretory urography revealed the signs of hydronephrosis and hydrocalycosis. There was no need for additional adjustments to perform the procedure in patients with a height of under 75 cm. The authors employed erosive operating conditions of a shock-wave generator for lithotripsy in case of large or dendritic calculi and to avoid preliminary renal drainage. One treatment session was a success in 43 patients, 2 sessions were needed for 15, 3 for 4 and 4 for 2 patients. A beneficial effect (total disintegration and fragmental discharge) was reached in 64 (98.4%) of the patients. Partial disintegration was recorded only in 1 patient who was exposed to 2 sessions. Radioisotope, immunological, ultrasonic, and biochemical investigations failed to reveal inhibition of the renal functional parameters after remote lithotripsy. No renal injuries associated with hematogenesis were revealed in the parents. The signs of hematuria were observed in the first portion of the postoperative urine only. The only serious complication calling for close attention is acute pyelonephritis observed in 6 patients, one case requiring a surgical application of nephrostoma.