Paediatric stone treatment in the Nordic countries – a multicentre study from the Scandinavian Collaboration Group for Urinary Stones

OBJECTIVE: To explore differences and similarities in paediatric stone treatment between hospitals in the Nordic countries. MATERIAL AND METHODS: A retrospective review of the medical records was performed for children receiving stone treatment in nine Nordic hospitals between January 2014 and December 2023. Variables of interest included diagnostic imaging, treatment modalities, complication rates and stone free rates (SFR). RESULTS: Five hundred and sixty two treatments among 319 children were included; 117 girls and 202 boys with a median age of 10 years (interquartile range 5 - 14). Preoperative diagnostic imaging with computed tomography was performed in 442 cases (79%), and 120 patients (21%) were diagnosed with ultrasound, MRI or X-ray. In 150 cases (27%), stones treated were located in the ureter only and in 412 cases (73%) in the renal pelvis ± ureter. Ureteroscopic stone treatment (URS) was performed in 248 (44%), shock wave lithotripsy (SWL) in 242 (43%) and percutaneous lithotripsy (PCNL) in 72 cases (13%). The distribution of treatment modalities varied considerably between hospitals. URS treatments increased, and SWL procedures declined throughout the study period. A follow-up consultation was carried out in 505 cases (90%). Overall SFR after each session across treatment modalities and location was 49%. The SFRs after URS was 68%, SWL 30% and PCNL 61% and significantly higher after URS compared to SWL, p < 0.001. Postoperative complications leading to readmission occurred in 10% of patients. CONCLUSION: The study reveals differences in preferred treatment modalities and results between the hospitals. Standardising diagnostics, treatment and follow-up could improve outcomes for children with kidney stone disease.