In this editorial the authors emphasize some aspects on stone removal. The text has its focus on the currently less common use of ESWL. Some important considerations are presented. Whereas the more invasive procedures URS and PNL are associated with higher stone-free rate than ESWL, considerable experience and expertise are necessary to avoid serious complications.

Whether asymptomatic residual fragments need to be further treated remains a matter of debate.

Hans-Göran Tiselius