When surgeons remove patients' kidney stones, they typically leave behind small stones that appear not to be causing problems. A new randomized controlled study showed, however, that leaving these asymptomatic stones behind significantly increases the risk of a patient's relapse in the following five years. The findings were published in the New England Journal of Medicine.
The investigators studied the 75 patients who were treated at multiple institutions over a span from 2015 to 2021. About half of the patients had only their large primary stone treated, while the others had primary and secondary stones removed. Relapse was defined as having to go to the emergency room or undergo an additional procedure due to a recurrence or if a follow-up CT scan showed that the secondary stones grew.
Removal of the secondary stones reduced the relapse rate by 82%, the researchers found, leading the authors to recommend that smaller stones should not be left behind.