Streeper NM, 2018: Asymptomatic Renal Stones-to Treat or Not to Treat.
Streeper NM.
Division of Urology, Penn State Milton S. Hershey Medical Center, Mail Code H055, 500 University Drive, PO Box 850, Hershey, PA.
Abstract
PURPOSE OF REVIEW: There are no current guidelines on the optimal management of asymptomatic renal stones. This review summarizes the current literature, focusing on more recent studies that have been done to grow the body of evidence on this topic.
RECENT FINDINGS: Recent studies have found that stone size is a significant predictor of need for future surgical intervention, with > 7 mm for pediatric population and > 4 mm for residual fragments after both PNL and ureteroscopy (URS). The role of URS has been better defined with a recent RCT concluding that URS and SWL had comparable outcomes for an asymptomatic lower pole stone < 1 cm. The treatment decision for asymptomatic renal stones should take into consideration a variety of relevant patient and stone factors; however, ultimately, a shared decision-making approach should be used. In the properly counselled patient, active surveillance or prophylactic surgical intervention may be appropriate.
Curr Urol Rep. 2018 Mar 17;19(5):29. doi: 10.1007/s11934-018-0782-3. Review.
Comments 1
This is a well written bias-free publication with a lot of good facts and clear cut recommendations. Get a copy and read it! You will need it when counselling a patient with an asymptomatic stone and you should have it in mind or in your computer.