Studies compare ureteroscopy with shockwave lithotripsy and with percutaneous nephrolithotomy
WEDNESDAY, Aug. 13, 2025 (HealthDay News) — In two studies published online July 22 in JAMA Network Open, surgical interventions are compared for children and adolescents with kidney stones.
Gregory E. Tasian, M.D., from The Children”s Hospital of Philadelphia, and colleagues compared stone clearance and patient-reported outcomes among 1,142 children and adolescents (aged 8 to 21 years) after ureteroscopy or shockwave lithotripsy in a nonrandomized clinical trial. A total of 124 urologists treated 1,069 and 197 kidneys or ureters with ureteroscopy and shockwave lithotripsy, respectively (953 and 189 patients, respectively). The researchers found that stone clearance occurred in 71.2 and 67.5 percent of patients who underwent ureteroscopy and shockwave lithotripsy, respectively, a difference that was not statistically significant. Ureteroscopy resulted in greater pain interference and urinary symptoms one week after surgery compared with shockwave lithotripsy.
Jonathan S. Ellison, M.D., from the Medical College of Wisconsin in Milwaukee, and colleagues compared clinical and patient-reported outcomes for percutaneous nephrolithotomy versus ureteroscopy in 1,039 children and adolescents with kidney and/or ureteral stones. Overall, 126 urologists performed percutaneous nephrolithotomy for 98 kidneys and/or ureters and ureteroscopy for 1,069. The researchers found that stone clearance was 67.2 and 73.4 percent for percutaneous nephrolithotomy and ureteroscopy, respectively, a difference that was not statistically significant. For stones larger than 15 mm, stone clearance was 94.0 and 55.0 percent for percutaneous nephrolithotomy and ureteroscopy, respectively, a difference that was statistically significant. At one week after surgery, percutaneous nephrolithotomy was associated with significantly lower pain intensity, pain interference, psychological stress experience, sleep disturbance, and urinary symptoms.
“Our findings provide new information that allow for tailored approaches to kidney stone treatment for children and their families,” Tasian said in a statement.
Several authors from both studies disclosed ties to the pharmaceutical and medical technology industries.
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