# Li A. et al., 2026: Evaluating the incidence of nephrolithiasis surgery before and after parathyroidectomy. Peter Alken Wednesday, 16 September 2026 238 Hits [ 0 Comments ](https://www.storzmedical.com/en/disciplines/literature-database-blog/database-lithotripsy/li-a-et-al-2026/?layout=listings#comments) Li A, Song D, Rangel MJ, Lim K, Bandari J, Jain RK, Moore A, Moalem J, Quarrier SO. Int Urol Nephrol. 2026 Jun;58(6):1957-1962. [doi: 10.1007/s11255-025-04930-3](https://pubmed.ncbi.nlm.nih.gov/41317237/). Epub 2025 Nov 29. ## Abstract Purpose: Primary hyperparathyroidism (PHPT) patients who undergo parathyroidectomy (PTX) have significantly reduced rates of kidney stone events based on imaging and patient-reported history. However, there has been limited knowledge on the impact of PTX on stone disease requiring surgical intervention. The aim of this study was to compare the incidence of kidney stone surgery before and after PTX. Methods: PHPT patients who underwent PTX from 2015-2023 at our institution were retrospectively reviewed. We evaluated the incidence of kidney stone treatment by shockwave lithotripsy (SWL), ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) based on CPT codes. Univariate and multivariate analyses were performed to compare the incidence rate before and after PTX. Results: We included 1554 patients who underwent PTX and identified 101 kidney stone surgeries. Patients were 75% female, 16% non-white race and had a median age of 63 years (IQR 55-71) at the time of PTX. The median follow-up time was 5.2 years before and 3.3 years after PTX. The incidence of kidney stone surgery in patients pre- vs post-PTX was 80 events/7668 person-years (1.0%) vs 21 events/5318 person-years (0.4%) respectively, (p < 0.0001). Thus, the incidence rate of requiring stone surgery decreased by 2.64 times following PTX (95% CI 1.62-4.50, p < 0.0001). The cases of URS and SWL decreased whereas the cases of PCNL increased (p < 0.02). Conclusion: The incidence of stone disease requiring surgical intervention significantly decreased following PTX. It remains critical to screen recurrent stone formers for PHPT, as surgical correction with PTX may help reduce subsequent stone surgeries and associated comorbidities. ## Comment Peter Alken SWL is not in the focus of this paper. The stone cases after PTX was mostly treated by PNL. The authors speculate: “One hypothesis for the increased PCNL cases is that these treated large non-obstructing renal stones present before PTX rather than newly formed large stone”. Like this the whole story about surgery before and after PTX is rather dubious. They don’t give information about the stone status in that time period. Could have been that the stones were already in the kidneys but PTX was first done. Peter Alken 0 #### Comments No comments made yet. Be the first to submit a comment Monday, 09 November 2026 I have read and agreed to the [Privacy Policy](https://www.storzmedical.com/javascript:void(0);)