Ureteroscopy, in conjunction with holmium laser lithotripsy and stone basketing, continues to be the preferred therapeutic modality when treating most stones in the pediatric population. Performing ureteroscopy has become an easily acquired skill that is routinely embraced by pediatric urologists worldwide. Most importantly, flexible and rigid ureteroscopy is well tolerated by children with extraordinarily high success rates and few complications. Unlike shock wave lithotripsy, ureteroscopy is cost-effective, readily available in the acute and elective setting, and controlled by the pediatric urologist as one is not beholden to an SWL technician. Although there is a positive role for SWL in treating pediatric uroli-thiasis, endoscopic techniques almost always take precedence.
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