During the past four decades there have been dramatic developments in the methods used for active stone removal from the urinary tract, and the need for open surgery has been almost entirely replaced by extracorporeal shockwave lithotripsy, percutaneous surgery, ureteroscopy and retrograde intrarenal surgery. Residual fragments and the pronounced risk of recurrent stone formation remain important problems for the future development of urolithology and for the optimal low-risk management of this large group of patients. It is emphasized that all aspects of the care of patients with stone disease are the responsibility of the urologist.
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