Indications for surgical removal, including asymptomatic stones

Abstract

The advent of minimally invasive methods of treating renal calculi has widened the indications for treatment beyond those stones causing significant pain, urinary tract infection, or obstruction. Despite the low morbidity of minimally invasive treatments, we must continue to balance risks and benefits of treatment versus conservative management in individual patients. For each patient there will be considerations relating to their age, occupation, comorbidity, stone history, and anatomy amongst many factors that will shape the most appropriate clinical treatment of their stone. We attempt to help rationalize these decisions and examine the knowledge we have in particular of the natural history of asymptomatic renal calculi, whose treatment remains most controversial. © 2011 Springer-Verlag London Limited.