Objectives:

At the conclusion of this activity, the learner should be able to:

1. Demonstrate knowledge of the current European and American guidelines for the treatment of symptomatic & asymptomatic renal stones
2. Interpret data in a large, randomized control trial.
3. Review the financial cost of urological stone procedure
4. Interpret data suggesting for/against the removing small, asymptomatic renal stones during surgery for a ureteral or contralateral stone resulted in fewer subsequent emergency department visits and surgeries and less stone growth than leaving the secondary stones in place.

Bio:

During the removal of symptomatic stones from the kidneys or ureters, other small, asymptomatic renal stones are often noted on imaging studies.¹ Current U.S. and European guidelines are equivocal; the U.S. guidelines suggest that asymptomatic renal stones may be actively monitored but that patients who have small, residual renal-stone fragments after surgery should be offered endoscopic surgery to remove them. U.S. and European guidelines cite several studies showing that patients with asymptomatic renal stones and fragments had approximately a 50% chance of relapse within 5 years after surgery. This study is the only long term, randomized control trial that suggests the removal of small, asymptomatic kidney stones during surgery to remove ureteral or contralateral kidney stones resulted in a lower incidence of relapse than non-removal and in a similar number of emergency department visits related to the surgery. 

ATTENDANCE / CREDIT
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TRANSCRIPT
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