Ulvik Ø. et al., 2026: Paediatric stone treatment in the Nordic countries - a multicentre study from the Scandinavian Collaboration Group for Urinary Stones.

Ulvik Ø, Vigrestad L, Helgø D, Øverby S, Larssen KS, Nurminen P, Ingimarsson JP, Åkerlund J, Ferrito R, Thiel T.
Scand J Urol. 2026 Jun 12;61:170-177. doi: 10.2340/sju.v61.46270 FREE ARTICLE

Abstract

Objective: To explore differences and similarities in paediatric stone treatment between hospitals in the Nordic countries.

Material and methods: A retrospective review of the medical records was performed for children receiving stone treatment in nine Nordic hospitals between January 2014 and December 2023. Variables of interest included diagnostic imaging, treatment modalities, complication rates and stone free rates (SFR).

Results: Five hundred and sixty two treatments among 319 children were included; 117 girls and 202 boys with a median age of 10 years (interquartile range 5 - 14). Preoperative diagnostic imaging with computed tomography was performed in 442 cases (79%), and 120 patients (21%) were diagnosed with ultrasound, MRI or X-ray. In 150 cases (27%), stones treated were located in the ureter only and in 412 cases (73%) in the renal pelvis ± ureter. Ureteroscopic stone treatment (URS) was performed in 248 (44%), shock wave lithotripsy (SWL) in 242 (43%) and percutaneous lithotripsy (PCNL) in 72 cases (13%). The distribution of treatment modalities varied considerably between hospitals. URS treatments increased, and SWL procedures declined throughout the study period. A follow-up consultation was carried out in 505 cases (90%). Overall SFR after each session across treatment modalities and location was 49%. The SFRs after URS was 68%, SWL 30% and PCNL 61% and significantly higher after URS compared to SWL, p < 0.001. Postoperative complications leading to readmission occurred in 10% of patients.

Conclusion: The study reveals differences in preferred treatment modalities and results between the hospitals. Standardising diagnostics, treatment and follow-up could improve outcomes for children with kidney stone disease.

Comment Hans-Göran Tiselius

In this report the authors summarize the treatment of stones in paediatric patients: ureter 27% and ureter + kidney 73%. The results shown are recorded for the Nordic countries.

The methods selected for stone removal varied (URS 248, SWL 242 and PCNL 72) and so did the results. Not unexpectedly, the results of URS were superior to those of SWL; 79% and 34% stone-free after one session.

I note that 30% of the SWL procedures were completed in sedation only. My reflection is that for most children this kind of pain treatment is insufficient for effective SWL.

This report does not add anything further that needs to be commented.

Hans-Göran Tiselius