Operation is usually advised and performed if a patient is found to have a renal calculus. For various reasons, however, certain persons who have nephrolithiasis are not treated surgically at the time when this diagnosis is first established. The minute nature of the calculus, the complete absence of symptoms, the presence of serious disease elsewhere in the body, advanced pathologic changes in the urinary tract, and other reasons may apparently render operation unnecessary or undesirable. Some patients who are not operated on progress quite satisfactorily under medical management and no serious symptoms referable to the urinary tract develop. Unfortunately, this is not generally true, as in the majority of cases symptoms of varying severity occur sooner or later and may render subsequent operation imperative or even jeopardize the patient's life.
It therefore seemed worth while to determine, if possible, the factors which influence the clinical course of a patient with