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Advances in Urology
Volume 2012 (2012), Article ID 320104, 5 pages
Review Article

Management of Clinically Insignificant Residual Fragments following Shock Wave Lithotripsy

Unità Complessa di Urologia, Ospedale Regionale Ca'Foncello, Treviso, Italy

Received 20 January 2012; Revised 25 February 2012; Accepted 28 February 2012

Academic Editor: Noor Buchholz

Copyright © 2012 Elisa Cicerello et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Clinically insignificant residual fragments (CIRFs) are small fragments (less than 5 mm) that are present in upper urinary tract at the time of regular post-SWL followup. The term is controversial because they may remain silent and asymptomatic or become a risk factor for stone growth and recurrence, leading to symptomatic events, and need further urologic treatment. Although a stone-free state is the desired outcome of surgical treatment of urolithiasis, the authors believe that the presence of noninfected, nonobstructive, asymptomatic residual fragments can be managed metabolically in order to prevent stone growth and recurrence. Further urologic intervention is warranted if clinical indications for stone removal are present.