Management of urinary stones in the patient with spinal cord injury

The main objective of the urologist treating patients with spinal cord injury is to preserve renal function. In order to minimize morbidity, all attempts must be made to maintain a low bladder pressure, sterile urine, and a non-obstructed drainage system. These patients remain at increased risk of infection and stone formation despite all clinical intervention. Diligence in routine follow-up and careful evaluations will provide the best possible results. In the face of urolithiasis, ESWL, percutaneous nephrolithotomy, and chemolysis are effective means of treatment with acceptable morbidity. With future technologic advancements and implementation of neurostimulators to improve the urodynamic profiles, the incidence of renal insufficiency, urolithiasis, and overall morbidity in patients with spinal cord injury is likely to decrease.