title: Optimal management of lower pole stones: the direction of future travel.
abstract: BACKGROUND
  Kidney stone disease is increasing worldwide with its most common location being in the lower pole. A clear strategy for effective management of these stones is essential in the light of ever increasing choice, effectiveness, and complications of different treatment options.
  
  
  METHODS
  This review identifies the latest and clinically relevant publications focused on optimal management of lower pole stones.
  
  
  RESULTS
  We present an up-to-date European Association of Urology and American Urological Association algorithm for lower pole stones, risks and benefits of different treatments, and changing landscape with the miniaturization of percutaneous stone treatments.
  
  
  CONCLUSIONS
  Available literature seems to be deficient on quality of life, patient centered decision making, and cost analysis of optimal management with no defined standard of 'stone free rate', all of which are critical in any surgical consultation and outcome analysis.
authors.affiliation: Department of Urology, University Hospital Southampton NHS Trust, United Kingdom.
authors.forename: Sacha L
authors.initials: SL
authors.lastname: Moore
authors.affiliation: Department of Urology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Bres-Niewada
authors.affiliation: Department of Biochemical Pathology, University Hospital Southampton NHS Trust, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Cook
authors.affiliation: Department of Urology, University Hospital Southampton NHS Trust, United Kingdom.
authors.forename: Hannah
authors.initials: H
authors.lastname: Wells
authors.affiliation: Department of Urology, University Hospital Southampton NHS Trust, United Kingdom.
authors.forename: Bhaskar K
authors.initials: BK
authors.lastname: Somani
keywords: kidney stones; lower pole stone; treatment; ureteroscopy; urolithiasis