Urinary Stone Diseases: The Practical Guide to Medical and Surgical Management

Abstract

This text book is divided into four sections. The background section presents the history, epidemiology and genetics of stone disease, theories of stone formation and analysis of kidney stones. Chapter 1 gives a well-researched walk through the surgical history of stone management from the ancient Egyptians to the rapid changes in technology of the last century, which have shaped our present-day stone management. Chapter 3, on genetics, reveals the complexity of the subject as well as the difficulties in translating a known specific gene defect into the metabolic fault that predisposes to stone disease. Chapters 6–19 make up section 2 on metabolism, which deals with various metabolic causes of stone formation. This section highlights the complex interplay of internal (genetic and metabolic) and external (diet, climate and concurrent illness) factors that influence urolithiasis. While a great deal of research has helped our understanding of stone disease, the complete understanding of why some patients do not form stones in spite of abnormal physiological factors remains an enigma. Section 3 on presentation and evaluation comprises four chapters, chapters 20 and 23 discussing imaging techniques, anatomical considerations and the benefits of a multidisciplinary approach in selecting the best management option. Radiation and infection safety guidance is presented in chapter 21. Differential diagnosis of loin pain and the initial management of the acute presentation of renal colic are dealt with in chapter 22. Section 4 on treatment makes up the remaining third of the book, covering conservative management, palliation with ureteral stenting and the three main areas of intervention. Open stone surgery is rare in the developed world and the authors in this chapter describe fully the surgical techniques used for the complex staghorn calculi. The role for open cystolitholapaxy is still important yet is not included in this chapter. In this section, I found a fair amount of overlap between the chapters, which is probably inevitable given the closely related chapter titles, such as ‘Indications and outcomes of ureteroscopy’ and the following chapter ‘Ureteroscopy: Technical aspects’. Nevertheless the chapters stand well on their own and the authors have comprehensively presented the evidence in support of the various treatments. Possibly the biggest omission in the conservative management is the use of α-blockers in facilitating the passage of lower ureteric stones. The aim of the editors to ‘put together … contemporary views on the development, treatment and prevention of urinary stone disease’ is successfully achieved in this textbook. The chapters are well researched and written by experts. There could be greater use of tables, as in chapter 29, to present the outcomes of the treatment modalities. For the jobbing urologist, sections 3 and 4 are the most interesting and the conclusion at the end of each chapter and sections on ‘pearls and tricks’ are particularly useful. This textbook describes the practice of stone management in the developed world and is aimed at both the urologist who has a general interest in urolithiasis as well as specialists in the field. It would be a useful addition in any urology and lithotripsy unit.