Methods: A professional research librarian carried out literature searches for all sections of the urolithiasis guidelines, covering the timeframe between 1976 and June 2023.
Key findings and limitations: For every patient with urolithiasis, an attempt should be made to analyse the stone. Patients should be given general instructions on how to prevent recurrence, including adequate fluid and calcium intake, and low consumption of sodium and protein. Identifying and correcting the causative factors is a cornerstone
in preventing the recurrence of urolithiasis. Diagnostic and therapeutic algorithms by stone composition are available. Every patient should undergo baseline metabolic screening, while patients with calcium stones, who are at high risk of relapse and complications, should undergo extensive metabolic screening with two 24-h urine collections and should receive targeted therapy. Patients with uric acid, infection, or cystine stones are at high risk of relapse. All patients at high risk of recurrence should be closely monitored, especially those not complying with therapy in the long term.
Conclusions and clinical implications: Metabolic stone evaluation and patient follow-up are highly recommended to prevent urolithiasis recurrence.
Andreas Skolarikos a, Bhaskar Somani b, Andreas Neisius c, Helene Jung d, Alec Petřík e, Thomas Tailly f, Niall Davis g, Lazaros Tzelves a, Rob Geraghty h, Riccardo Lombardo i, Carla Bezuidenhout j, Giovanni Gambaro k
- National and Kapodistrian University of Athens, 2nd Department of Urology, Sismanogleio Hospital, Athens, Greece
- Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Department of Urology, Hospital of the Brothers of Mercy Trier, Medical Campus University Mainz, Trier, Germany
- Urinvejskirurgisk Afdeling, Sygehus Lillebælt, Vejle, Denmark
- Department of Urology, Region Hospital, Ceske Budejovice, Czechia
- Servicio de Urología, Hospital Universitario de Gante, Gante, Belgium
- Department of Urology, Connolly Hospital, Dublin, Ireland
- Department of Urology, Freeman Hospital, Newcastle-upon-Tyne, UK
- Sant ’Andrea Hospital, Sapienza University, Rome, Italy
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
- Division of Nephrology and Dialysis, Department of Medicine, University of Verona, Verona, Italy