Surgical Management of Kidney and Ureteral Stones: AUA Guideline (2026). Part II: Evaluation and Treatment of Patients With Kidney and/or Ureteral Stones

PURPOSE: This Guideline covers the surgical management of patients with kidney and/or ureteral stones and is intended for clinicians evaluating and managing patients with this disease. The summary presented herein represents Part II of the 3-part series dedicated to Surgical Management of Kidney and Ureteral Stones. Please refer to Parts I and III for additional information on this topic. MATERIALS AND METHODS: This systematic review was conducted in 2 planned stages, including a search for systematic reviews followed by a search for primary literature. OVID was used to systematically search MEDLINE and EMBASE databases for articles evaluating surgical management of kidney and ureteral stones. The Panel selected control articles that were deemed relevant and the articles were compared with the literature search strategy output. The methodologist then updated the strategy as necessary to capture all control articles. Databases were searched for studies published from January 2000 through May 2025 (week 20). In addition to the MEDLINE and EMBASE databases searches, reference lists of included systematic reviews and primary literature were scanned for potentially useful studies. RESULTS: The Panel addressed adult and pediatric patients with kidney and/or ureteral stones for whom surgical intervention may be indicated. Each statement herein addressed a particular patient scenario for which the choice of surgical intervention was reviewed and justified. In addition, the Panel reviewed and analyzed the utility of specific surgical techniques, technologies, or medications aimed at improving patient outcomes. CONCLUSIONS: Selection of optimal treatment modalities for patients with kidney and/or ureteral stones is determined by patient factors, urinary tract anatomy, and stone characteristics and are guided by shared decision-making that additionally takes into account patient goals and preferences, resource availability, and physician expertise. This Guideline serves as a resource for clinicians and patients to provide the best available evidence on which to base discussions with patients in a shared decision-making process to arrive at appropriate treatment decisions.