Urinary stone disease occurs in paediatric patients and requires clinical management tailored to this age group. Structured guidance exists for children under 18 presenting with urinary stones, including specific approaches for stones in the distal ureter.
This protocol covers patients under 18 years of age with urinary stone disease. The indications for procedural interventions — including shock wave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PCNL) — in children are similar to those applied in adults.
For eligible distal ureteric stones, off-label medical expulsive therapy may be offered as a pharmacological option to support stone passage. The complete clinical criteria, decision pathway, and structured regimen are available in the full protocol.
In children, the indications for SWL, URS and PCNL are similar to those in adults.
Several systematic reviews and meta-analyses, including six RCTs and one conference abstract of an RCT, have been performed, all unanimously reporting that the use of α-blockers for distal ureteric stones increases the stone-free or stone expulsion rate.
The use of α-blockers also reduces the stone expulsion time and decreases the number of pain episodes and the need for analgesia, with the disadvantage of more side-effects such as headache and nasal congestion.
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