Abu Dhabi, United Arab Emirates (UAE) (UroToday.com) Dr. Bhaskar K. Somani, a urologist from the University Hospital of Southampton, spoke at the World Congress of Endourology’s ESUT-EULIS Joint Session on Tuesday regarding how the management of 1-2cm renal stones depends largely on an individual’s unique stone properties. Stone locations, volumes, and morphologies vary from person to person, and, with such a variety of stone pathologies, there have been several ureteroscopic and PCNL techniques that have been created to address selective forms of treatment. However, Dr. Somani explains that with the advent of so many novel techniques, such as ultra-PCNL, mini-PCNL, and micro-PCNL (just to name a few), there is uncertainty as to what treatment modality is best suited for certain small renal stones, their location, and various properties (HU, skin-to-stone distance, etc.).

During his presentation, Dr. Somani asked the audience “what do we hope to achieve with small renal stones?” While a number of answers were given, Dr. Somani emphasized that the ultimate end goal of treating small renal stones is to achieve a good stone free rate (SFR), minimize the incidence of residual stones and, thus, the need for repeat procedures, reduce patient’s level of pain and anxiety regarding their procedure, reduce complications, create reproducible and highly effective surgical techniques, and improve the patient counseling and informed consent process.

Dr. Somani spent the remainder of his presentation explaining the current state of how various PCNL and URS procedures are utilized for different diameter stones. While Dr. Somani meticulously classified the most common procedures utilized for various stone sizes and spoke on the benefits and drawbacks of each with respect to cost and known complication rates in published meta-analyses, he emphasized that it is important for clinicians to remember that each patient’s anatomy and stone-forming capabilities vary from one another and that a personalized approach to selecting a treatment modality to alleviate a patient’s stone burden must be always be taken into account when treating small renal stones.

Presented by: Dr. Bhaskar K. Somani, MD, FEBU, FRCS(Urol), University Hospital of Southampton, ESU Training and Research Group (Southampton, England) 

Written by: Andrew Shea Afyouni, BS, Junior Research Specialist and Medical Student, University of California, Irvine Department of Urology. Medical Writer for UroToday.com at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates