2011
DOI: 10.1111/j.1464-410x.2011.10329.x
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Outcomes of long‐term follow‐up of patients with conservative management of asymptomatic renal calculi

Abstract: Study Type – Prognosis (cohort) Level of Evidence 4 What’s known on the subject? and What does the study add? Several small series studies have looked at the natural history of asymptomatic renal stones. The number of subjects in these studies ranged from 24 to 300 and duration of follow‐up ranged from 19.4 to 52.3 months. The reported incidences of spontaneous passage, progression and intervention were 3 to 15%, 33 to 77% and 7 to 26%. This study reports on the natural history of asymptomatic stones with an a… Show more

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Cited by 52 publications
(54 citation statements)
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“…A retrospective study of 50 patients with smaller asymptomatic stones (mean size 5.7 mm in a total of 85 stones) reported rates of Key points ■ The prevalence of asymptomatic stones identified in screened populations is 8-10%, and is likely to grow with increased CT utilization ■ Outcomes of asymptomatic stones <10 mm in diamater include a symptomatic stone event (13-32%), spontaneous passage (13-20%), size increase (30-46%) and intervention (7-26%) ■ Asymptomatic stones located in the renal pelvis and >15 mm are at high risk of progression, defined as increase in size, symptomatic stone event, or need for intervention ■ Shockwave lithotripsy does not improve stone-free rates or quality of life compared to observation for asymptomatic calyceal stones <15 mm ■ Percutaneous nephrolithotomy improves stone-free rates compared to shockwave lithotriposy and observation for asymptomatic lower pole stones ■ Randomized trials are needed to define the role of ureteroscopy in the management of asymptomatic renal stones spontaneous passage, size increase, and intervention of 20%, 46%, and 7%, respectively. 12 A single prospective study has been performed in patients with asymptomatic lower pole stones, who were followed with observation for a mean of 52.3 months. 13 24 patients (27 affected renal units) with a mean stone size of 8.8 mm were followed prospectively, 12.5% of whom developed pain, and 12.5% required intervention.…”
Section: Natural History Of Asymptomatic Stonesmentioning
confidence: 99%
“…A retrospective study of 50 patients with smaller asymptomatic stones (mean size 5.7 mm in a total of 85 stones) reported rates of Key points ■ The prevalence of asymptomatic stones identified in screened populations is 8-10%, and is likely to grow with increased CT utilization ■ Outcomes of asymptomatic stones <10 mm in diamater include a symptomatic stone event (13-32%), spontaneous passage (13-20%), size increase (30-46%) and intervention (7-26%) ■ Asymptomatic stones located in the renal pelvis and >15 mm are at high risk of progression, defined as increase in size, symptomatic stone event, or need for intervention ■ Shockwave lithotripsy does not improve stone-free rates or quality of life compared to observation for asymptomatic calyceal stones <15 mm ■ Percutaneous nephrolithotomy improves stone-free rates compared to shockwave lithotriposy and observation for asymptomatic lower pole stones ■ Randomized trials are needed to define the role of ureteroscopy in the management of asymptomatic renal stones spontaneous passage, size increase, and intervention of 20%, 46%, and 7%, respectively. 12 A single prospective study has been performed in patients with asymptomatic lower pole stones, who were followed with observation for a mean of 52.3 months. 13 24 patients (27 affected renal units) with a mean stone size of 8.8 mm were followed prospectively, 12.5% of whom developed pain, and 12.5% required intervention.…”
Section: Natural History Of Asymptomatic Stonesmentioning
confidence: 99%
“…With long-term follow-up, *20% of asymptomatic stones with mean size <6 mm passed spontaneously, while 45% remained within the kidney but enlarged, and 7% ultimately required intervention. 7 Most small asymptomatic stones could be managed conservatively, but some patients might desire a noninvasive method to facilitate stone passage due to personal preference or occupational requirements (e.g., pilots). A provoked, but controlled stone event could avoid the unpredictability of stone passage while on observation.…”
Section: Role In Endourologymentioning
confidence: 99%
“…[1][2][3][4][5][6] Small asymptomatic stones that are followed rather than treated may also ultimately require intervention. 7 Likewise, patients presenting with an acute obstructing stone and signs of infection, hemodynamic instability, renal insufficiency, or intractable nausea or pain, may require an urgent procedure to provide drainage of the obstructed kidney. 8 Currently, the only options to relieve obstruction are surgical.…”
Section: Introductionmentioning
confidence: 99%
“…In einer in 2011 publizierten Studie haben Koh et al [22] Zusammenfassend kann trotz der überschaubaren und teilweise widersprüchlichen Datenlage Patienten mit asymptomatischen Unterkelchsteinen ein abwartendes Vorgehen bis zu einer Steingröße von ca. 1 cm angeboten werden und mit dem gut informierten Patienten gegenüber den Risiken und Nutzen einer Intervention abgewogen werden [32].…”
Section: Beobachtendes Abwarten (Kontrollieren)unclassified