PCNL Technique Produces Better Outcomes for Kids with Large Kidney Stones
Research By: W. Robert Defoor, MD
Post Date: June 10, 2025 | Publish Date: June 2025
Urology | Top Scientific Achievement
A major North American study has shown that percutaneous nephrolithotomy (PCNL) offers better outcomes for children and adolescents with large kidney stones than ureteroscopy (URS).
The study, published in June 2025 in JAMA Network Open, was conducted through the Pediatric Kidney Stone (PKIDS) Care Improvement Network, a collaborative research network of 31 medical centers in the U.S. and Canada. W. Robert DeFoor, MD, MPH, from Cincinnati Children’s, was a co-author.
The study followed 1,039 patients ages 8 to 21 between 2020 and 2023. While overall stone clearance rates were similar between procedures—67% for PCNL and 73% for URS—PCNL was far superior for stones larger than 15 mm, clearing 94% compared to 55% for URS. Children undergoing PCNL also reported less pain, anxiety, sleep disturbance, and urinary symptoms one week after surgery.
“These findings challenge long-held assumptions about surgical options for pediatric kidney stones,” DeFoor says. “By focusing on both stone removal and the patient’s lived experience, we’re helping redefine what quality care looks like for children.”
The results strengthen support for PCNL as the preferred treatment for large stones and highlight the need for updated guidelines that reflect real-world practice. The PKIDS Network is now planning a prospective clinical trial to confirm these results and further improve surgical care for pediatric patients.
About the study
Additional collaborators included investigators from the Children’s Hospital of Philadelphia, Boston Children’s Hospital, Ann & Robert H. Lurie Children’s Hospital of Chicago, Nationwide Children’s Hospital, Riley Hospital for Children, UCLA Mattel Children’s Hospital, and 25 other institutions across the PKIDS Care Improvement Network.
This research was supported by the Patient-Centered Outcomes Research Institute (PCORI) (CER-2018C3-14778) and the National Institutes of Health (DK119535).
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| Original title: | Percutaneous Nephrolithotomy vs Ureteroscopy for Kidney Stones in Children |
| Published in: | JAMA Network Open |
| Publish date: | June 2025 |
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