Urinary stones in children are less common than in adults and are rare in the spectrum of childhood urologic diseases, but the incidence of urinary stones in children has increased significantly in recent years, with marked geographical differences in incidence, etiology, stone characteristics and distribution. Calcium oxalate is the most predominant component of urinary stones in children, the rest being calcium phosphate, magnesium ammonium phosphate, cystine salt, and uric acid stones. What do we need to know about ureteral stones in children? What are the risk factors for the formation of urinary stones? 1, abnormal urinary metabolism: abnormal urinary metabolism is an important factor affecting the formation of urinary stones, which can be caused by a variety of etiologies and often exists in multiple types and in a comprehensive manner in children with urinary stones, including: hypercalcemia, hypocitraturia, hyperoxaluria, hyperuricemia, cystinuria, etc. 2, systemic metabolic abnormalities: systemic metabolic disorders such as diabetes mellitus, hypertension, obesity, etc. are associated with the development of urinary stones in children. Obesity is currently considered to be the most important cause of stones. The latter will aggravate the degree of obstruction and infection. Clinically, obstructive diseases that easily cause the formation of urinary stones include pelvic ureteral junction stenosis, ureteral bladder junction stenosis, spongy kidney, renal ureter malformation, etc. 4. Diet and medications: Food metabolism plays a large role in the formation of urinary stones in children, and different combinations and changes in diet reduce the risk of stones in children. Drug use can also trigger the production of urinary stones, mostly related to metabolism. Drugs that cause urinary stones can be broadly classified into two categories: one is metabolic stones by triggering abnormal urinary metabolism, such as excessive vitamin D leading to increased urinary calcium; oxalic acid as a metabolite of vitamin C. High doses of vitamin C intake are associated with the occurrence of hyperoxaluria; the second category is due to the low solubility of the drug itself or its metabolites in the urine, and when the concentration is too high, it precipitates and causes stones, representing The drugs are sulfa, indinavir and ceftriaxone, with ceftriaxone sodium causing a higher percentage of stones. What are the common diagnostic methods? 1.Ultrasound: Ultrasound is easy, economical, non-invasive, and can detect stones of 2mm or more, and is the preferred method of examination for stones. 2, Urogram (KUB plain film): It can detect about 90% of X-ray positive stones, and can determine the location, shape, size and number of stones. 3.Non-enhanced CT scan (NCCT): its examination has high resolution and can detect stones over 1mm, and can clearly show the morphology, size, and location of stones including X-ray negative stones, and can also determine the composition of stones initially by the CT value of stones, which has greater value for the selection of clinical treatment. 4.Isotope: It cannot directly show the stones, but it can show the morphology of the urinary system and provide information on renal blood perfusion, renal function and urinary tract obstruction, which is of value for the selection of surgical plan and evaluation of surgical efficacy. 5.Endocrine metabolic assessment: Children’s urinary stones are mostly accompanied by metabolic abnormalities, so it is crucial to perform metabolic assessment in children, including blood analysis, urine analysis, stone analysis and the current more accurate genetic analysis. Metabolic assessment and analysis can help to clarify the causes of stone development, which can reduce the recurrence of stones at source and truly achieve accurate medical treatment. What are the clinical symptoms of ureteral stones? Most ureteral stones in children have no clinical symptoms. Common clinical symptoms include hematuria, lumbar and abdominal pain or with nausea and vomiting, urinary tract infection, etc. Most of the clinical drug stones are characterized by lumbar and abdominal pain, anuria or oliguria, accompanied by nausea and vomiting, poor nausea and other gastrointestinal symptoms. What are the treatment methods of ureteral stones in children? 1.Conservative treatment: For ureteral stones below 6mm in diameter, conservative observation treatment is preferred, through drinking more water, proper exercise and oral lithotripsy drugs. 2.Extracorporeal shock wave lithotripsy: The efficacy of ESWL is related to the size of the stone, the degree of stone encapsulation by the ureteral mucosa and the composition of the stone, and the re-treatment rate of large and dense stones is high. For upper ureteral stones ≤1cm in diameter, ESWL is the first option, and for upper ureteral stones >1cm, ESWL, ureteroscopic lithotripsy and percutaneous nephrolithotomy are available. ESWL and ureteroscopic lithotripsy can be chosen for middle and lower ureteral stones, but ureteroscopic lithotripsy is preferred. Ureteroscopic lithotripsy: firstly, it is suitable for lower and middle ureteral stones, which have higher stone removal rate, and secondly, it can be used for upper ureteral stones that failed ESWL treatment and “stone street” after ESWL treatment. 4.Laparoscopic treatment: It is suitable for ESWL and ureteroscopic lithotripsy, failed stone extraction and stone combined with ureteral stenosis. Through the above methods, the majority of ureteral stones in children can obtain satisfactory treatment results, but the treatment is not over, how to prevent the recurrence of urinary stones in children, it is a long way to go, we still need to continue to work hard.