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The advances in technological equipments in the last decade for the treatment of pediatric stone disease has significantly improved outcomes. A variety of nephroscopes of different sizes which can be used for different age groups are available on the market to treat kidney stones. Flexible ureteroscopes, ultrathin ureteroscopes, and other sizes of semirigid ureteroscopes are also available for the treatment of ureteral and upper urinary tract calculi in children. In addition to the advancement of the finer instruments, laser technology with different powers has improved fragmentation of the stones. The advancement of stone retrival devices and baskets facilitated the procedures by decreasing the complications. Open stone surgery has almost disappeared and together with laparoscopy, it is only reserved for stones in children with anatomical abnormalities (pelvic kidneys, spinal deformities, etc.). Beyond surgical alternatives, although its use has proportionally decreased over time, shock wave lithotripsy is here to stay as a valuable option. Nevertheless, personalized management is the key to treat pediatric stone disease and it is the task of the surgeons to find out the best alternative according to the size and location of the stone, and age and body size of the child. Future technical improvements are also awaited and will soon improve the efficiency of the current endourological procedures.

Shock wave lithotripsy (SWL) for the treatment of pediatric stone disease was initiated almost three decades ago, ushering in a new era of noninvasive techniques for stone disintegration in children. Initially, all urinary stones—regardless of their size, site, or composition—were treated by this modality, eliminating the necessity of open surgery. SWL became less painful and more accessible for children when modern modular lithotripters, with smaller foci and better stone-targeting options, were introduced. Stone-free rates (SFRs) vary between 46% and 100%, depending on patient, lithotripter, and stone factors. Short- and long-term complications are rare. Recent refinements in endoscope design and intrarenal and ureteral imaging have added percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS) as alternatives to SWL for stone disintegration in children and infants. The main advantage of these modalities over SWL is their ability to actively remove stone fragments from the urinary system to achieve better SFRs compared with SWL in ureteral and large renal calculi. Current stone management guidelines for children have been established and updated by the European Association of Urology. Hand- and robot-assisted laparoscopic pyelolithtomy have recently been introduced for special cases. We conclude that SWL is an effective and safe treatment modality for small renal stones and for upper ureteral calculi but not for cysteine stones. URS is very efficient for distal ureteral stones and recently has become more popular for renal stones. PCNL is the first-line treatment for large or staghorn calculi.

Purpose of review Renal transplant is needed for end-stage renal disease. Although treatment of donor stones may be needed pretransplant and increases the pool available for renal transplant, posttransplant stone disease may also need treatment to maintain the allograft function. A Cochrane style review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to evaluate the outcomes of donor and posttransplant ureteroscopy (URS) for stone disease, including all English language articles between January 1996 and December 2018. Recent findings Eighteen articles (167 patients), seven ex-vivo or donor URS and 11 posttransplant URS met inclusion criteria and were included in the review. A pretransplant URS showed a stone-free rate (SFR) of 100% with an overall complication rate of 7.5% (four Clavien I and one Clavien ≥3), where as a posttransplant URS showed SFR of 100% in five studies and 60-91% in four studies with an overall complication rate of 12.9% (10 Clavien I and three Clavien ≥3). Summary Advancements in endourological technique has made URS for donor and posttransplant urolithiasis a safe and effective procedure. Although data were based on small retrospective caser series, it shows that in experienced centres it can be performed with low morbidity and a high SFR.

Epidemiologic aspects of urinary tract stone disease are presented as a background for understanding of the clinical impact of this pathologic condition. The principles for and the determinants of the formation of calcium stones, uric acid stones, infection stones, and cystine stones are briefly discussed in a way that should provide a necessary basis for the design of rational recurrence preventive measures. Emphasis is placed on the mechanisms behind calcium oxalate stone formation. The article highlights some recent observations and conclusions of importance for a better understanding of how stones form and of how recurrence prevention can best be achieved.

Every year, an increasing quantity of new information is presented at the major urologic and oncologic congresses such as the European Association of Urology (EAU), the American Urological Association (AUA), the American Society of Clinical Oncology (ASCO), and so forth. Because of the delay until final publication of these data, it is very difficult for urologists to keep up to date with the new scientific information relevant for their own clinical practise. In light of this difficulty, a closed expert meeting "New Horizons in Urology" (NHU) was held in October 2006 in Marbella, Spain. The objective of this meeting was to provide practising urologists with the most important information with practical clinical relevance to urologists presented during the major urologic and oncologic meetings. This information was selected and presented by leading experts in the field of functional and oncologic urology. Nonmalignant disease areas that were considered were surgical interventions for lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH), benign bladder diseases, and stone disease. Malignant disease topics were prostate cancer, bladder cancer, and kidney cancer. Each session started with a clinical case workshop during which the attendee's opinion on the management of the clinical case was assessed via interactive voting, followed by a discussion of the expert panel. The sessions were closed with a brief update lecture. The current paper summarises the highlights of the closed expert meeting.

Introduction The goal of this original work was to describe papillary abnormalities using flexible ureteroscopy into a new classification and to assess their relation with stone composition.