Vol. 7, Issue 2, Part B (2025)

There is a growing global recognition of pediatric stone disease and differs significantly from adult urolithiasis in etiology, presentation, and management. Calcium-containing stones remain the most prevalent, but rarer types as cystine, uric acid, struvite, xanthine, and drug-induced stones require careful metabolic and genetic evaluation to prevent recurrence. Advances in pediatric urology over the past two decades—including the development of child-appropriate instruments, minimally invasive surgical techniques, and improved understanding of genetic and metabolic contributors have significantly enhanced outcomes. Current management strategies emphasize a tailored approach, integrating the child’s anatomy, stone composition, and metabolic profile. Non-invasive and minimally invasive interventions as ESWL, RIRS, and PCNL, supplemented by laser lithotripsy using Holmium:YAG or Thulium fiber lasers, have become standard practice, achieving high stone-free rates while minimizing complications. Nevertheless, careful perioperative monitoring and post-procedure metabolic evaluation remain essential to ensure long-term renal protection and reduce recurrence.