Abstract

The major concern following minimally invasive stone removal procedures is related to the presence of residual fragments, parts of the original stone or unaffected stones. There is definitely a consensus that symptomatic residuals need to be eliminated. On the other hand, for patients with asymptomatic residuals there are different attitudes. Some urologists propose an aggressive treatment aiming at a complete clearance of the renal collecting system, whereas others apply a conservative approach with or without a regular follow-up programme. The major question in this regard is whether all stone material residing after active stone removal - irrespective of symptoms - should be considered as failures in need of additional stone removing procedures. The answer to that question should be sought in long-term follow-up studies of such patients. The published data has clearly shown that majority of patients treated with non-invasive or low-invasive stone removing procedures, calcium stone residual fragments usually do not require aggressive re-treatment with the aim of removing every little fragment from the kidney. They need, however, metabolic and recurrence preventive considerations.