Korean J Urol.  2004 Dec;45(12):1183-1200.

Urolithiasis: Medical and Surgical Treatments

• Moon YT

Abstract

In the management of patients with urolithiasis, there has been a significant change during the last two decades. The change includes major innovations involving introduction of percutaneous nephrolithotripsy (PNL) and the development of extracorporeal shock wave lithotripsy (ESWL) which have replaced open surgery. Additionally, the development of ureteroscopy with refinement of instrumentation and stone fragmenting devices has allowed for safer, improved management of ureteral stones. These endourological treatments have greatly benefitted the stone-forming patient, and further developments and refinements in these new technologies will follow. Unfortunately, those advances related to the removal and fragmentation of stones have not been paralleled by advances in understanding of the etiology and pathogenesis of urolithiasis and its prevention. Knowledge gained from research has continued, but these developments have often times been overshadowed by the more dramatic improvements in surgical technology. It is important to remember that the etiology of urolithiasis can be identified in most patients and this information may be applied to reduce or prevent stone-recurrences. In this review, I attempt to address the current methods of treating all aspects of urolithiasis. Principles of patient evaluation and medical management are detailed, as are the newer interventional and technological developments including chemolysis, intracorporeal lithotrispsy, ESWL, and open surgery.

MeSH Terms

Humans
Lithotripsy
Shock
Ureter
Ureteroscopy
Urolithiasis*