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We agree with most of the observations made in the editorial comment. Many recent reports have proven the safety and efficacy of ESWL in the management of pediatric renal stones. Our report has also shown that 20 to 30-mm stones could be treated with very high success rates by in situ ESWL. Perhaps the only issue left, in the group with larger stones (greater than 20 mm), is the use of ureteral stents. We believe that ureteral stents do not reduce post-ESWL complications. They are clearly associated with morbidity and do not improve stone passage markedly.1 Results from our prospective work (unpublished) with in situ treatment of renal stones greater than 20 mm have been encouraging.

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References 

1. Bierkens AF, Hendrikx AJ, Lemmens WA, et al.  Extracorporeal shock wave lithotripsy for large renal calculi (the role of ureteral stents. A randomized trial). J Urol. 1991;145:699–702
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