Asymptomatic Stones: Remove Each Piece? Or Leave in Peace?

Benjamin K. Canales, MD, MPH

Benjamin K. Canales, MD, MPH presented “Asymptomatic Stones: Remove Each Piece? Or Leave in Peace?” during the 42nd Annual Ralph E. Hopkins Urology Seminar on February 1, 2023, in Jackson Hole, Wyoming.

How to cite: Canales, Benjamin K. “Asymptomatic Stones: Remove Each Piece? Or Leave in Peace?.” February 1, 2023. Accessed Oct 2026. https://grandroundsinurology.com/asymptomatic-stones-remove-each-piece-or-leave-in-peace/

Asymptomatic Stones: Remove Each Piece? Or Leave in Peace? – Summary

Benjamin K. Canales, MD, MPH discusses the prevalence and natural history of asymptomatic kidney stones, emphasizing that while these stones may not initially cause symptoms, they have the potential to lead to significant complications, including pain, infection, and obstruction. He identifies various factors that influence the decision-making process, such as stone size, location, composition, and patient-specific factors including age, comorbidities, and risk of future stone-related events.

Dr. Canales discusses the current guidelines and evidence-based practices for managing asymptomatic stones, including the benefits and risks associated with both intervention and observation. He highlights the criteria for selecting patients who may benefit from proactive treatment, such as those with high-risk anatomical features or a history of recurrent stones, and scenarios where a conservative approach, involving regular monitoring and preventive measures, may be more appropriate.

Technological advancements and surgical techniques have improved the safety and efficacy of stone removal procedures. Dr. Canales reviews minimally invasive options, such as ureteroscopy and percutaneous nephrolithotomy, and their role in the management of asymptomatic stones. The presentation includes a discussion on the potential complications of these procedures and the importance of patient counseling to set realistic expectations.

About The 42nd Annual Ralph E. Hopkins Urology Seminar:

The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, sexual function, emerging surgical techniques, and general urology. The 42nd iteration of the meeting took place from February 1st to 4th, 2023, in Jackson Hole, Wyoming.

For further educational activities from this conference, visit our collection page.

ABOUT THE AUTHOR

Benjamin K. Canales, MD, MPH

Benjamin K. Canales, MD, MPH, is Associate Professor and Director of Urologic Research in the Department of Urology at the University of Florida College of Medicine. Dr. Canales’ clinical interests include urologic stone disease, endourology, and laparoscopy. He has particular clinical interests and skills in minimally invasive urologic surgery, laparoscopic nephrectomy, laparoscopic prostatectomy, laparoscopic partial nephrectomy, endourology, and kidney stone disease/pathogenesis.

About The Author

Benjamin K. Canales, MD, MPH

Benjamin K. Canales, MD, MPH, is Associate Professor and Director of Urologic Research in the Department of Urology at the University of Florida College of Medicine. Dr. Canales’ clinical interests include urologic stone disease, endourology, and laparoscopy. He has particular clinical interests and skills in minimally invasive urologic surgery, laparoscopic nephrectomy, laparoscopic prostatectomy, laparoscopic partial nephrectomy, endourology, and kidney stone disease/pathogenesis. Dr. Canales earned his medical degree from the Louisiana State University School of Medicine in New Orleans. He completed his residency at the University of Minnesota Medical School in Minneapolis, and then completed a fellowship in laparoscopy and endourology at the University of Minnesota, Minneapolis-St. Paul. Dr. Canales’ postdoctoral training in the Department of Urologic Surgery at the University of Minnesota includes serving as a fellow and clinical instructor in laparoscopy, endourology, and robotics, completing a urology residency, and completing a general surgery internship. Dr. Canales has received numerous honors and awards over his career, including the University of Florida College of Medicine Exemplary Teacher award in 2022. Dr. Canales serves on many academic and professional committees, including the University of Florida College of Medicine Scientific Review Committee, the Endourological Society Research Committee, and the American Urological Association International Academic Fellowship Committee. He is a co-author on three publications and one journal article, and was a Principal Investigator for the University of Florida’s Comparison of Obturator Nerve Blockade and Neuromuscular Blockade clinical trial. Dr. Canales is certified through the American Board of Urology.

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