This Month in Adult Urology

摘要

Natural History of Nonobstructing Renal Calculi: Should we treat asymptomatic, noninfectious renal stones and if so which ones? Dropkin et al (page 1265) from Hanover, New Hampshire identified 160 stones in 110 patients with a followup of 41 ± 19 months of which 28% caused symptoms. Three stones (3% of the asymptomatic subgroup and 2% of all stones) caused painless silent obstruction requiring intervention at an average of 37 ± 17 months. The only significant predictor of symptoms or spontaneous passage was location, with upper pole/mid renal stones more likely to become symptomatic (40.6% vs 24.3%, p=0.047) and to pass spontaneously (14.5% vs 2.9%, p=0.016). Most patients with asymptomatic calculi on active surveillance remained asymptomatic at 3 years. Less than 30% of the stones cause renal colic.