Management of Ureteral Stones in Pediatric Patients

Purpose: We report our 5-year experience in the management of ureteral stones in pediatric patients using shockwave lithotripsy (SWL) in combination with ureteroscopy. Patients and Methods: A total of 25 children (age range 12 months-14 years; mean 8.7 years) underwent SWL for ureteral lithiasis. Stones were located in the upper ureter in 6 children (24%), the middle ureter in 8 (32%), and the lower ureter in 11 (44%). Their size ranged from 5 to 14 mm (mean 10.9 mm). The children who failed SWL underwent ureteroscopic treatment. Results: In the SWL-only group, the overall stone clearance rate at 3 months was 84% (21 of 25 children). Four children (16%) who failed SWL underwent successful ureteroscopic treatment. Complications were infrequent and generally minor in both groups. Conclusions: Shockwave lithotripsy is a safe and efficient treatment modality for ureteral stones in pediatric patients. In expert hands, ureteroscopy can be successfully applied in case of SWL failure.