Therapeutic options for the management of upper tract calculi.

The cry of "ESWL for all" was heard at the 84th Annual Meeting of the American Urological Association, and actually, this is not far from the truth. Those physicians who are not familiar with percutaneous techniques, or who do not have the necessary equipment available, may actually attempt ESWL for all calculi regardless of stone burden or location. Patients who are interested in avoiding manipulation may request ESWL, even if the results may not be as good as those obtained with concomitant manipulation or with percutaneous procedures. Nevertheless, indications still exist for percutaneous techniques, and these procedures will not become obsolete even as ESWL technology advances. Studies are being conducted to identify the ideal treatment for all varieties of stones in the genitourinary system. As ESWL and endoscopic technology continue to advance, the treatment of stone disease will continue to change.