A week or two later, the urologist will take out the stent and remove the stone, most often by ureteroscopy. This involves inserting the ureteroscope through the bladder and capturing the stone in a basket, sometimes after breaking it into fragments via laser lithotripsy.
Extracorporeal shock wave lithotripsy, in which several thousand shock waves are directed at the stone, is still widely performed in adults. It is less popular in children because of the theoretical risk of damaging nearby healthy tissues, which might then result in hypertension or diabetes.
Although the majority of cases of pediatric urolithiasis are managed on an outpatient basis, today roughly 1 in 1,000 pediatric hospitalizations is for kidney stones. The explanation for the increase in kidney stones in children over the past decade isn’t entirely clear. Increased consumption of salty, high-protein, processed foods and decreased water intake have been implicated.
General measures for prevention of stones in a stone-forming child include ample fluid intake – more than 2 L daily in teens – along with a healthy diet featuring liberal consumption of fruits and vegetables to increase excretion of stone-inhibiting citrate into the urine. Restriction of dietary calcium isn’t recommended, even in calcium stone formers.
"I usually tell patients to drink enough fluids that their urine looks very dilute. You don’t want dark yellow urine," Dr. Vogt said.
She reported having no financial conflicts.