Kidney stones are rare in children. They are often the result of a metabolic disorder (e.g. cystinuria) or a mechanical obstruction of the urine flow (e.g. ureteral outlet stenosis with recurrent urinary tract infections.

Kidney stones can be the starting point for urinary tract infections and recurrent urinary tract infections can lead to stone formation. Kidney and ureteral stones also cause cramp-like pain (colic).

In almost all cases, the cause of the stone formation should be treated first (stone prophylaxis) before attempting to remove the stones. Modern medicine offers many options for this, which can also be used in very young children (see below).

The fragmentation of stones using extracorporeal shock wave lithotripsy (ESWL) is the most commonly used procedure and a gentle method. The stones are destroyed under ultrasound guidance and then excreted naturally with the urine.

Stones, which are localized in the ureters and usually cause severe pain, have become stuck on their way from the kidney to the bladder. If all conservative measures and the use of ESWL have been unsuccessful, these stones can be removed by endoscopic endoscopy of the bladder and ureter. The same applies to bladder stones, which are located by cystoscopy and then broken up with a laser.

Large stones that are stuck in the renal pelvis or calyces and cannot be removed by ESWL can be removed by percutaneous nephrolithotomy (PCNL). In this minimally invasive technique, a working channel is advanced through the skin into the cavities of the kidney. The stones can then also be broken up by laser under visual control.

Thanks to very small instruments, all of these procedures can now also be performed on small children and even infants. Of course, these procedures are only performed under general anesthesia.

The treatment of kidney, ureter and bladder stones is interdisciplinary. The Departments of Pediatric Surgery, Urology and Pediatric Nephrology are always involved on the basis of a jointly developed therapy concept. It does not matter in which of these three departments the patient was initially treated. First, the cause of the stone disease is investigated and then an individual treatment concept is developed. The top priority is to remain as conservative as possible, i.e. to avoid open surgery if possible. Of course, this also includes measures to prevent stones.

The question of which treatment should be prioritized in each case cannot be answered in general terms at this point and is reserved for the individual consultation of each patient.