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Asymptomatic renal stones often are found incidentally on abdominal imaging done for unrelated reasons or during evaluation of patients with symptomatic passage of ureteral stones. In this retrospective study from a single U.S. urological practice, researchers examined the natural history of 160 asymptomatic renal stones (mean size, 7 mm) in 110 adults. Most patients (87%) had experienced previous symptomatic ureteral stones. Patients underwent routine renal ultrasound imaging every 6 to 12 months.
During average follow-up of 3.5 years, 45 stones (28%) became symptomatic, and 27 of them required intervention. Additionally, 3 stones caused painless silent hydronephrosis that resulted in intervention. About 20% of stones grew in diameter by >5…