Current management of urinary tract stones

A review of the current management of urinary tract stones as applied to the University Department of Surgery is presented. The use of allopurinol and alkalinisation of urine is effective in dissolution and prevention of uric acid stones. Cellulose phosphate and thiazide therapy for calcium stone formers have a limited place, as we are still unable to identify those who will benefit from such therapy in the local population. Antegrade pyelogram and percutaneous nephrostomy have useful roles to play in investigation and also management of patients with calculous anuria. The use of regional renal hypothermia has enabled us to operate with more confidence on branched or multiple renal calculi. With better visual lithotrite, more and bigger stones in the lower urinary tract can now be removed endoscopically.