Management of stone disease

Urolithiasis is common, affecting 10% of Caucasian men. Factors affecting stone formation can be intrinsic to the individual and are influenced by environmental factors.Patients presenting with loin/groin pain to the surgical team are common and ureteric colic should be considered in this group. The relevant investigations with regards to blood, urine and imaging tests to diagnose stone disease are discussed. In addition, the absolute indications for urgent intervention are reviewed.Treatment for ureteric stones and renal calculi includes a wide armamentarium of endourological techniques including extracorporeal shock wave lithotripsy, ureteroscopy and percutaneous nephrolithotomy, if conservative therapy fails.Therapy is guided by anatomical factors, stone factors, previous treatment failures as well as the patient’s wishes.Indications, contraindications and complications of the common procedures are discussed.