Guidelines and medical management of stone disease: Do we have a consensus?

Abstract

Medical management of the stone disease is a topic of controversy even between worldwide guidelines. With this review, we attempt to clarify the disparities that exist in the literature and provide to the clinical urologist a tool for battling this common disease. The search was based on current Guidelines from national and international urological Associations including European and American guidelines and the guidelines of Societe d”Urologie. The use of a-blockers is highly indicated by most Guidelines as medical expulsion therapy, whereas nonsteroidal anti-inflammatory medication for pain relief. Fluid intake of 2 lit/day, controlled dietary calcium consumption and sodium restrictions are universal dietary modifications from urological Associations on the prevention of stone disease. Despite methodological heterogeneity and subjective rating of recommendations, an acceptable degree of consensus was noted on Guidelines regarding medical management of the stone disease.