Manoj J. Monga, MD, FACS, presented “Point-Counterpoint: 24-Hour Urine Tests vs. Empiric Therapy – Empiric Therapy” during the 30th Annual Perspectives in Urology: Point-Counterpoint, on March 10, 2023, at Humphreys Half Moon Inn, San Diego, California.
How to cite: Monga, Manoj J. “Point-Counterpoint: 24-Hour Urine Tests vs. Empiric Therapy – Empiric Therapy.” March 10, 2023. Accessed Nov 2024. https://grandroundsinurology.com/point-counterpoint-24-hour-urine-tests-vs-empiric-therapy-empiric-therapy/
Point-Counterpoint: 24-Hour Urine Tests vs. Empiric Therapy – Empiric Therapy – Summary
Manoj J. Monga, MD, FACS, presents his argument for empiric therapy over 24-hour urine testing in kidney stone evaluation. Dr. Monga begins by explaining empiric therapy, including empiric dietary therapy, and describes it as a conservative treatment plan. He displays data on the effects of drinking fluids on reducing recurrence of kidney stones, as well as the positive effect of fruit and vegetable intake in terms of reducing kidney stone recurrence.
Dr. Monga then shifts gears to empiric medical therapy, displaying encouraging study data on the use of thiazides to reduce stone recurrence. He also displays data on citrates and stone recurrence, pointing out that this data is weaker, and asserting that citrates should not always be used with patients with kidney stones.
Dr. Monga acknowledges that not many stone patients—even high-risk stone patients—get a 24-hour urine test and that number is actually dropping. He also displays data showing that the use of a 24-hour urine test has no bearing on three-year recurrence across patient populations. Dr. Monga concludes by citing this lack of supporting data for the 24-hour urine test, and re-emphasizes the ease, speed, and efficacy of empiric therapy for patients suffering with kidney stones.
This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: 24-Hour Urines vs. Empiric Therapy–24-Hour Urine Tests.”
About the 30th Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.
ABOUT THE AUTHOR
Manoj J. Monga, MD, FACS, is Professor and Chair of Urology at the University of California, San Diego. He previously served as Director of the Stevan B. Streem Center for Endourology & Stone Disease at the Glickman Urological and Kidney Institute at the Cleveland Clinic and the Joseph Sorkness Family Endowed Professor and Vice-Chair of Urologic Surgery and Director of Endourology & Stone Disease at the University of Minnesota. Dr. Monga received his medical degree from the Chicago Medical School and completed his residency at Tulane University School of Medicine.
Dr. Monga is recognized as an international authority in endourology and stone disease, and has been an invited speaker in India, Thailand, Brazil, Italy, Greece, Mexico, China, United Kingdom and the Netherlands. He has also acted as a Visiting Professor at many of the major medical centers in the United States.
Dr. Monga has served on numerous AUA committees, including the Quality Improvement & Patient Safety Committee, Abstract Committee, and Urology Care Foundation’s Outreach Committee. He also served as Chair of the North Central Section’s Education Committee. Dr. Monga has served as the section editor of the Journal of Endourology and served on several other editorial boards, including the Indian Journal of Urology and the International Brazilian Journal of Urology.
