The Current Role of Medical Treatment of Nephrolithiasis: The Impact of Improved Techniques of Stone Removal

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Abstract
To document more clearly the effect of selective medical treatment on the course of nephrolithiasis, 103 consecutive patients being followed up were surveyed. Of the patients who initially had existing stones within the kidneys, 69% experienced no symptoms while undergoing medical therapy, compared to 96% of those who had no existing stones. In all subjects studied, new stone formation was reduced in > 95% and no new stones were formed in > 75%. An operation for newly formed calculi was necessary in only 2% of the patients on medical therapy, whereas 58-69% of the patients required an operation for new stones before beginning medical treatment. Selective medical treatment apparently has an important role in the over-all management of nephrolithiasis. Appropriate medical therapy may decrease significantly the number of new stones formed and obviate the need for a repeat stone operation. Therefore, medical treatment should be an important adjunct to percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy.

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