title: Treatment of pediatric renal stones in a Western country: a changing pattern.
abstract: BACKGROUND
  Over the last 10years the miniaturization of endoscopic instruments made minimally invasive procedures for kidney stones feasible even in children. The evolution in management of kidney stones in a tertiary care center in Europe is reported.
  
  
  METHODS
  Patients treated in our hospital for kidney stones from 2002 to 2011 were reviewed and group A (2002 to 2006) was compared with group B (2007 to 2011). The therapeutic options offered were Extracorporeal Shock Waves Lithotripsy (ESWL), Retrograde Intrarenal Surgery (RIRS), Percutaneous Lithotripsy (PCNL) and open surgery. Outcome measures were: first treatment chosen, stone free rate after a single procedure, and retreatment. Results were compared by chi-square test, with p <0.05 considered statistically significant.
  
  
  RESULTS
  333 patients, mean age 9.7years, were treated, 161 in group A and 172 in group B. ESWL was the first option in both groups, but decreased by 34% in group B vs A. In contrast, RIRS and PCNL increased by 17% and 16%, respectively, in group B vs group A. Open surgery was never required in primary lithiasis cases without associated malformations.
  
  
  CONCLUSIONS
  The advent of PCNL and RIRS has significantly changed the pattern of renal stone treatment in the pediatric age group. A progressive increase of endourologic minimally invasive procedures was recorded. Open surgery should be a very rare option.
authors.affiliation: Division of Pediatric Urology, Department Nephrology and Urology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Salerno
authors.forename: Simona Gerocarni
authors.initials: SG
authors.lastname: Nappo
authors.forename: Ennio
authors.initials: E
authors.lastname: Matarazzo
authors.forename: Mauro
authors.initials: M
authors.lastname: De Dominicis
authors.forename: Paolo
authors.initials: P
authors.lastname: Caione
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D007669:Kidney Calculi / Q000453:epidemiology / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D016896:Treatment Outcome