Modern Pediatrics. Ukraine. (2026).3(155): 82-86. doi: 10.15574/SP.2026.3(155).8286
Nakonechnyi R. A., Nakonechnyi A. Y.
SNC «Danylo Halytskyi Lviv National Medical University», Ukraine

For citation: Nakonechnyi RA, Nakonechnyi AY. (2026). Treatment strategy for urolithiasis in children based on stone volume. Modern Pediatrics. Ukraine. 3(155): 82-86. doi: 10.15574/SP.2026.3(155).8286.
Article received: Jan 03, 2026. Accepted for publication: Apr 13, 2026.

Urolithiasis in children is a growing medical concern. The efficacy of its treatment depends on numerous factors, with stone burden being the key parameter.
Aim – to evaluate the efficacy of various treatment modalities for pediatric urolithiasis depending on stone volume and to determine its prognostic value for achieving a stone-free rate (SFR).
Materials and methods. A retrospective cohort study included 72 patients aged 1-17 years with solitary urinary tract calculi, treated between January 2023 and June 2025. Based on non-contrast computed tomography stone volume, patients were divided into three groups: Group I (less 100 mm³) – 37 (51.4%) children, Group II (101-200 mm³) – 21 (29.2%), and Group III (201-370 mm³) – 14 (19.4%). Extracorporeal shockwave lithotripsy (ESWL) was used as the first-line treatment; ureterorenoscopy and retrograde intrarenal surgery were performed as secondary interventions when necessary. The SFR was assessed at 3 months. Statistical analysis was performed with the Kruskal-Wallis and Spearman correlation tests.
Results. The overall SFR was 93.1%: 100% in Group I, 90.5% in Group II, and 78.6% in Group III. Secondary interventions were required in 47.6% of patients in Group II and 57.1% in Group III. A significant positive correlation was found between stone volume and the number of secondary interventions, as well as between patient age and stone volume. The Kruskal-Wallis test showed a highly significant difference in treatment outcomes (single intervention, secondary intervention, residual stone fragments) across the three groups depending on stone volume.
Conclusions. Stone volume is a key predictor of treatment success in pediatric urolithiasis, directly correlating with the need for secondary interventions. For stones up to 100 mm³, first-line ESWL demonstrates maximum efficacy. As stone volume increases, the probability of requiring additional endourological procedures to achieve SFR rises significantly.
The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from the patients.
The authors declare no conflicts of interest.
Keywords: urolithiasis, kidney stones, stone volume, stone-free rate, children.

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