Recent data show a high recurrence rate in children with stones treated with either shock wave lithotripsy, ureteroscopy, or percutaneous nephrolithotomy, particularly in those with abnormal anatomy. In a study of 60 children, overall recurrence within 5 years was 55%; patients with abnormal anatomy had a 65% chance of stone recurrence compared with 38% for those with normal anatomy. These findings support the aggressive diagnosis and treatment of metabolic abnormalities in children.