[Urinary calculous disease--a saga of urological field in Japan]

The management of urinary calculous disease has been a treasured place also in urological history of Japan. Recently, innovatory procedures for stone removal have been introduced and the excellent advances of Endourology and ESWL (extracorporeal shock wave lithotripsy) revolutionized the surgical treatment of renal calculous disease. However, some thoughtful members of urologists have been afraid that the majority of the urological surgeons might believe if they have already completed the treatment of urolithiasis and succeeded the resolution on the patients with renal calculous disease. Now, I will write a saga of the investigations of this interesting and still important subject in the urological field of Japan, looking back my own way who have been interested in urolithiasis treatment and also its prophylaxis. The goal of the treatment for urinary calculous patients should be the prevention of recurrent stone formation because the surgical treatment is only the removal of existing stones, even recent advance of innovatory procedures could confer the less invasive benefits on urinary calculous patients. Some selective medical treatment programs have been introduced and emerged therapeutic importance to the prevention of renal stone formation and more will have elaborated in the future. Several investigations on the difficult mechanisms of stone formation have been also vigorously accomplishing by some urologists in Japan. I hope that I would anticipate what is to come on the entire solution of the precise mechanism of stone formation and ultimate control of urolithiasis by successional young urologic investigators in near future.