World Journal of Urology

, Volume 33, Issue 2, pp 203–211

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

Topic Paper

DOI: 10.1007/s00345-014-1353-y

Cite this article as:
Jung, H. & Osther, P.J.S. World J Urol (2015) 33: 203. doi:10.1007/s00345-014-1353-y



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.


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


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


Kidney calculi Ureteral calculi Acute management Imaging Ureteroscopy SWL Medical expulsive therapy Pregnancy Childhood 

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Urology, Urological Research CenterFredericia Hospital – a Part of Hospital LittlebeltFredericiaDenmark
  2. 2.Institute of Regional Health Services ResearchUniversity of Southern DenmarkFredericiaDenmark

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