Approximately 1 in 9 individuals in the United States will be diagnosed with a kidney or ureteral stone at some time in their lives. Although some stones remain asymptomatic and are evident only as an incidental finding on imaging studies obtained for unrelated reasons, others are manifested through episodes of pain, infection, or loss of kidney function. Acute symptoms from kidney or ureteral stones are responsible for over one million emergency department (ED) visits annually in the U.S., and many of these visits culminate in hospital admission and/or surgical intervention. This Guideline is intended to facilitate care decisions and aid clinicians in the surgical management of patients with kidney and ureteral stones. The multiple surgical treatment options are discussed and evaluated within this Guideline.

Safe, efficient, and cost-effective management of symptomatic and/or high risk renal and ureteral stones (i.e., large, obstructing, renal pelvis or ureteral, or infection-related stones or stones in anatomically or functionally solitary kidneys) requires careful planning based on patient history and relevant diagnostic imaging. Patient factors, anatomic considerations, and stone characteristics will determine the optimal timing and selection of surgical treatment modalities. Furthermore, appropriate and timely follow-up determines the success and identifies complications of surgical intervention. As such, topics covered in the Guideline include the following:

• Pre-operative evaluation and preparation
• Treatment of patients with ureteral stones
• Treatment of patients with kidney stones
• Treatment of pregnant patients