Management of Stones in Obesity

Abstract

The prevalence of overweight and obese individuals has significantly increased over time in the USA. Large population-based studies have shown that obesity and weight gain have increased the risk of kidney stone formation due to alterations in urinary metabolite excretion in adults. Regarding the adverse effects of comorbid disease and urolithiasis on kidney function together with the limitations of stone surgery, the medical management of stone disease seems to be the most important goal for preventing further recurrences in morbidly obese patients. Obesity poses a number of problems in the management of stone disease from diagnosis and imaging through to anesthesia and surgery. Some technical modifications were defined for increasing the success rates in extracorporeal shock-wave lithotripsy and percutaneous nephrolithotomy. The urologist needs knowledge and experience of potential diagnostic and treatment problems as well as modifications of the techniques for this patient group. © 2012 Blackwell Publishing Ltd.