Pediatric nephrolithiasis continues to pose a substantial clinical challenge in pediatric urology
because of its elevated recurrence rate and elevated morbidity with risk of end-stage renal failure. The man￾agement of pediatric nephrolithiasis involves dietary modification, pharmacological therapy, and urological
intervention, with the choice of treatment guided by stone size, location, and composition.
Objective: To evaluate the efficacy and safety of mini-percutaneous nephrolithotomy (mini-PCNL) and extrac￾orporeal shock wave lithotripsy (SWL) for the management of renal stones measuring 1–2 cm in pediatrics.
Cases and Methods: This prospective, randomized comparative research was conducted at the Department of
Urology, Al-Azhar University Hospital, Assiut, Egypt, between December 2022 and November 2024. Sixty
children with single renal stones were enrolled, with 30 undergoing SWL and 30 receiving mini-PCNL.
Results: Mini-PCNL achieved a significantly elevated stone-free rate (SFR, 93.33%) in contrast with SWL
(33.33%) (p < 0.001). The SWL group also showed a higher rate of auxiliary approaches and retreatment.
Overall complication rates were comparable.
Conclusion: Mini-PCNL is more effective than SWL for managing renal stones measuring 10–20 mm in chil￾dren aged 6 months to 6 years. It provides an elevated SFR and lowers the likelihood of retreatment and hos￾pital readmission, with a comparable safety profile.