Man MY. et al., 2026: Does surgical removal of kidney stones help prevent the recurrence of urinary tract infections? A systematic review.

Man MY, Somani B, Pietropaolo A.
Curr Opin Urol. 2026 Jan 1;36(1):103-111. doi: 10.1097/MOU.0000000000001328

Abstract

Purpose of review: Kidney stones disease (KSD) and urinary tract infections (UTIs) can be associated and reciprocally causal. Aim of this study is to understand the association between stone-free rate and infection clearance or recurrence after surgery.

Recent findings: Studies are suggesting that removing stones may help to prevent UTIs. A systematic review was done to look at the relationship between UTIs and kidney stones and to find out whether stone removal surgery can help to reduce UTIs. The systematic review was done as per PRISMA checklist and three databases (Ovid MEDLINE, Cochrane Library and Embase) were searched for articles reporting on patients with recurrent UTIs and kidney stone surgery. All studies in English language were included with 1009 articles identified between 2000 and 2024.In the 10 studies finally selected, 1731 stones procedures were performed. Nine studies demonstrated a significant correlation between stone clearance and resolution of urinary tract infections.

Summary: Surgical management of kidney stones appears to play a significant role in reducing UTI recurrence among patients with recurrent infections. Achieving stone clearance is associated with a higher likelihood of infection resolution and prolongation of infection-free intervals postoperatively.

Comment Hans-Göran Tiselius

The association between urinary stones and urinary tract infection is clinically well recognized. The pathology, however, has changed over time and infection stones caused by urease are less commonly encountered than was previously the case.  As shown in this review calcium stones, usually CaOx are most common.

The authors show that surgical removal of stones reduced the rate of recurrent UTIs. It is likely that stone material harbor bacteria and that stone removal accordingly decreases the rate of re-infection.

Treatment with antibiotics is only marginally discussed in this report, but it is likely that also partly disintegration of the stones may cause diffusion of antibiotics into the stone residuals.

The bottom-line of this review is that stone clearance was associated with a great chance of eliminating or decreasing UTI.

Hans-Göran Tiselius