[Treatment of upper tract stones and neurogenic bladder]

Upper tract stones are a frequent complication in neurourology and require specific treatment according to modalities adapted to the clinical setting. All modern treatment modalities for stones can be proposed: extracorporeal lithotripsy (ESWL), percutaneous nephrolithotomy and open surgery depending on the local conditions. The treatment objectives in the neurologically disabled population must be to combine a maximum of fragmentation and elimination in the same treatment session. ESWL therefore has a more limited place in this population. On the other hand, a renal stone measuring 1.5 cm must be treated by percutaneous surgery. Finally, management of upper tract stones depends on evaluation and stabilization of the lower tract (pressures, urinary tract infection, residual urine) to decrease the risk of recurrent stones.