According to the findings of a randomized experiment, eliminating tiny, asymptomatic kidney stones while performing endoscopic removal of ureteral or contralateral stones dramatically increased the time to relapse compared to non-removal.

Researchers included 38 patients (treated group) who had small, asymptomatic stones removed after the endoscopic removal of ureteral or contralateral kidney stones, while in 35 patients (control group) stones were not removed (control group).

It was observed that after a mean follow-up of 4.2 years, the treatment group had a longer time to relapse than the control group.   The average time to relapse was found to be around 4.5 years in the treatment group compared to approximately 2.5 years in the control group. The hazard ratio for relapse was reduced by 82% in the treatment group. Relapse occurred in 16% of patients with treated asymptomatic stones, in comparison to 63% of patients in the control arm, in terms of absolute numbers. Further, it was seen that within two weeks of surgery, five patients in the therapy group and four in the control group visited the emergency services. Ten patients in the control group and eight patients in the treatment group both reported passing renal stones.

Thus the study concluded that removing tiny, asymptomatic kidney stones as part of surgery to remove ureteral or contralateral kidney stones resulted in a reduced rate of relapse than non-removal. Additionally, both groups had a similar number of emergency visits related to the surgery. (MedPage Today August 10, 2022; N Engl J Med 2022; DOI: 10.1056/NEMoa2204253.)