title: Endoscopic stone management in children.
abstract: OBJECTIVE
  The management of urolithiasis in children has significantly changed over the past 20 years. Extracorporeal shockwave lithotripsy (SWL) was initially the preferred modality of treatment. More recently, ureteroscopy and percutaneous nephrolithotomy (PCNL) are being used at an increasing frequency in the management of pediatric stone disease.
  
  
  RESULTS
  Development has been made in various aspects of pediatric endoscopic stone management. Ureteroscopy and PCNL have been applied at an increasing frequency to treat pediatric stone disease, which has guided modifications to improve the procedures. Increased endoscopic experience with managing urolithiasis has broadened the indications wherein these methods are utilized. Technology is continually advancing to meet the needs of this population. Ureteroscopes have been modified to accommodate the pediatric ureter, optics advanced, and access sheaths are used to improve results. In addition, technique is constantly being refined.
  
  
  CONCLUSIONS
  Further experience will direct surgeons as to when ureteroscopy and PCNL are appropriate. The incidence of urolithiasis is on the rise in developing nations; there is a need to address the most efficient method of treatment that minimizes the morbidity to the child.
authors.affiliation: Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA. Gaayana.Raju@chp.edu
authors.forename: Gaayana A
authors.initials: GA
authors.lastname: Raju
authors.forename: Regina D
authors.initials: RD
authors.lastname: Norris
authors.forename: Michael C
authors.initials: MC
authors.lastname: Ost
mesh_terms: D002648:Child; D006801:Humans; D009403:Nephrostomy, Percutaneous; D018666:Ureteroscopy; D052878:Urolithiasis / Q000601:surgery*