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Acute management of stones: When to treat or not to treat?

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Abstract

Introduction

Stone management is often conservative due to a high spontaneous stone passage rate or non-symptomatic calyceal stones that do not necessarily require active treatment. However, stone disease may cause symptoms and complications requiring urgent intervention.

Material and methods

In this review, we update latest research and current recommendations regarding acute management of stones, with particular focus on imaging, pain management, active stone interventions, medical expulsive therapy, and urolithiasis in pregnancy and childhood.

Results

Acute stone management should be planned with careful consideration of stone size and location, symptoms, patient comorbidity and radiation dose.

Conclusion

In case of infective hydronephrosis, compromised renal function or persistent pain despite adequate analgesic treatment acute intervention is indicated.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, Urological Research Center, Fredericia Hospital – a Part of Hospital Littlebelt, Fredericia, Denmark

    Helene Jung & Palle J. S. Osther

  2. Institute of Regional Health Services Research, University of Southern Denmark, Fredericia, Denmark

    Helene Jung & Palle J. S. Osther

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  1. Helene Jung
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Correspondence to Palle J. S. Osther.

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Jung, H., Osther, P.J.S. Acute management of stones: When to treat or not to treat?. World J Urol 33, 203–211 (2015). https://doi.org/10.1007/s00345-014-1353-y

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