After stone passage or successful medical/surgical treatment, patients with risk of recurrence should be evaluated metabolically with serum studies and 24-hour urine for metabolic studies to determine whether any metabolic abnormalities exist that predispose to recurrent stone formation. Patients can then alter their diet/lifestyle or be placed on the appropriate medication if needed. Patients with cystine stones are more likely to require additional urologic interventions over time despite medical therapy and close follow-up.
Periodic 24-hour urine monitoring should be performed to assess the efficacy of dietary/lifestyle changes and medications. Imaging with noncontrast computed tomography (CT) scan or KUB should be carried out every 6-12 months to monitor for recurrence or increase in the size of existing stones.
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