Management of stones in neurological patients

Patients with neurological disorders and urinary stone disease pose a significant challenge to the urologist, and possibly as a consequence, the literature is sparse about this small but important group of patients who are at an increased risk of urolithiasis, complications following surgical intervention and stone recurrence. Thus, this review has included publications from the last 5 years.

In the last few years several studies have reported the challenge for getting these patients stone-free and highlighted the risk management issues that need to be covered when considering surgical intervention. Similarly, these patients are at increased risk of stone recurrence and the published literature illustrates the need for consistent posttreatment regimens to minimize further stone formation--an area which presents great opportunities for research. All the publications emphasize the need for these patients to be assessed in dedicated stone centres with access to all the various modalities for treatment.

Patients with spinal neuropathy and urolithiasis pose a significant operative challenge, and there needs to be an established set of evidence-based guidelines to assist medical decision making for this high-risk population group. Unfortunately, the evidence to date is weak and more work is necessary to provide the basis for improving patient care.