Treatment of isolated small renal stones leads to resolution of symptoms and should be routinely offered to patients: retrospective outcomes from a university hospital

Abstract

IntroductionTreatment of smaller renal stones and the symptomatic value it offers to patients is often debated. We wanted to analyse surgical outcomes for treatment of small renal stones and whether treatment resulted in symptom resolution.Materials and methodsAll patients who underwent ureterorenoscopy (URS) for isolated symptomatic small renal stones ≤10 mm over a 7-year period were retrospectively included and subdivided into those with stones of ≤7 mm (Group A) and stones of 8–10 mm (Group B). Patients with multiple renal stones, ureteric stones, or combined renal and ureteric stones were excluded. Based on the symptoms, the patient groups were those with pain, urinary tract infection (UTI) and haematuria. Resolution of symptoms was defined as no symptoms during the follow-up period.ResultsA total of 109 patients with a single small renal stone ≤10 mm underwent URS and stone treatment, with mean age of 50 years and a male:female ratio of 1:1.2. The mean operative time was significantly longer in Group B (55.9 min vs 33.07 min, p = 0.001). In total, 97.2% (n = 70) of patients in Group A and 83.7% (n = 31) of patients in Group B were stone free (p = 0.017). Complete resolution of symptoms was seen in 63 (92.6%), 24 (85.7%) and 13 (100%) patients with pain, UTI and haematuria, respectively. There were no statistically significant differences in symptom resolution between patients with stones ≤7 mm and those with stones 8–10 mm in size.ConclusionUreteroscopic treatment is a feasible option for small symptomatic stones, since it may lead to symptom resolution. Based on our study we would recommend that patients with symptomatic small renal stones are offered endoscopic treatment.