The last twenty years has seen the biggest revolution in the treatment
of renal tract stone that has ever been experienced in the history of
urolithiasis. The treatment of upper tract renal stone has progressed
from the days of a very traumatic and morbid procedure to the relatively
innocuous, walk in/walk out therapy of extracorporeal lithotripsy. This
progression of events has resulted in a complete reappraisal of
management of all types of urinary calculi. From an initial reluctance
to treat many stones because of the trauma involved, we have now passed
to a situation where smaller and asympto- matic stones may be
pre-emptively treated before the treatment of serious clinical problems.
It is true to say that in Westemized societies the problem of
urolithiasis has almost completely been solved by the advent of advanced
technology. In this volume, attention is drawn to the fact that there
are still persistent difficulties in treating urolithiasis in the less
developed and less affluent societies. The differences in epidemiology
of urolithiasis in various areas of the world are highlighted, noting a
rapid decrease in the incidence of bladder calculi in impover- ished
areas where affluence increases. Coupled with this progression of
affluence however is the well documented increase in the incidence of
upper tract renal stones of oxalate nature. This scenario has been
almost universal across all coun- tries in the last few decades.