[The dilemma of metaphylaxis of urinary calculi]

Drug therapy in terms of prophylaxis of recurrent urolithiasis is known to be successful in inborn metabolic disturbances as cystinuria, primary hyperoxaluria, inborn errors of purine metabolism and calculi due to urinary infection. At the time efficient regimes for the large group of idiopathic urolithiasis are not available. The reason is that pathophysiology of urinary stone formation is still not fully understood. As a consequence of changing therapy in terms of extracorporal shockwave therapy and endourological lithotripsy, intensity of basic research in this field has markedly decreased. Optimizing prophylactic therapy of urolithiasis could only be achieved by development of completely new strategies from basic research.