Surgical Management of Stones

1. Clinicians should obtain a non-contrast CT scan on patients prior to performing PCNL.

2. Clinicians may obtain a non-contrast CT scan to help select the best candidate for SWL versus URS.

3. Clinicians may obtain a functional imaging study (DTPA or MAG‐3) if clinically significant loss of renal function in the involved kidney or kidneys is suspected.

4. Clinicians are required to obtain a urinalysis prior to intervention. In patients with clinical or laboratory signs of infection, urine culture should be obtained.

5. Clinicians should obtain a CBC and platelet count on patients undergoing procedures where there is a significant risk of hemorrhage or for patients with symptoms suggesting anemia, thrombocytopenia or infection; serum electrolytes and creatinine should be obtained if there is suspicion of reduced renal function.

6. In patients with complex stones or anatomy, clinicians may obtain additional contrast imaging if further definition of the collecting system and the ureteral anatomy is needed.