Peter Schulam MD, PhD, presented “Surgical Management of Stone Disease” during the Jackson Hole Seminars on February 7, 2018 in Jackson Hole, Wyoming.

How to cite: SchulamPeter. “Surgical Management of Stone Disease” February 7, 2018. Accessed Mar 2024. https://grandroundsinurology.com/Surgical-Management-of-Stone-Disease/

Surgical Management of Stone Disease

Summary:

Peter Schulam MD, PhD, discusses the 2016 American Urological Association (AUA)/ Endourology Society guidelines regarding observation of renal calculi, the treatment of ureteral and renal stones, urolithiasis during pregnancy, and the role of open surgery in stone disease. Specifically, he discusses medical expulsive therapy (MET), ureteroscopy, and shockwave lithotripsy (SWL). He finishes the talk with a brief summary on the use of each treatment, and their indications for various stone sizes and populations.

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Reveal Answer to Twitter Question

What is the best treatment for a symptomatic 1.5 cm proximal ureteral stone?

  • A. In situ SWL
  • B. Stent placement and SWL
  • C. Ureteroscopy and laser lithotripsy 
  • D. Percutaneous stone removal 

Answer explanation: The answer is Option C, ureteroscopy. Both shockwave and ureteroscopy are acceptable first-line therapies. But, ureteroscopy is oftentimes better for stones that are greater than 1 cm.