Editing AUA: Stone Surgery (2016) (section)

=== Laboratory ===

* '''<span style="color:#ff0000">Urinalysis</span>''' +/- culture
** '''<span style="color:#ff0000">Required prior to intervention</span>'''
** '''In patients with clinical or laboratory signs of infection, urine culture should be obtained'''
*** If the culture demonstrates infection, appropriate antibiotics should be prescribed based on sensitivity
*** '''There can be discordance between preoperative voided urine cultures or those from indwelling urethral catheters compared to urine proximal to an obstructing stone.'''
**** '''<span style="color:#ff0000">Intraoperative urine cultures should be obtained, if technically feasible, from urine proximal to the stone if infected urine is suspected at the time of intervention.</span>'''
*** '''Additionally stone cultures may be obtained, especially in cases of suspected infection-related stones, in order to help guide postoperative therapy.'''
**** '''There is also potential discordance between stone cultures and preoperative voided urine cultures'''
* '''<span style="color:#ff0000">Serum electrolytes and creatinine</span>'''
** '''<span style="color:#ff0000">Should be obtained if there is suspicion of reduced renal function</span>'''
*** Reduced renal function is suspected in those with hydronephrosis, parenchymal thinning or co-morbid conditions associated with renal dysfunction and electrolyte disturbances
* '''<span style="color:#ff0000">CBC and platelet count</span>'''
** '''<span style="color:#ff0000">Should be obtained for patients:</span>'''
**# '''<span style="color:#ff0000">Undergoing procedures where there is a significant risk of hemorrhage</span>''' (e.g. PCNL)
**# '''<span style="color:#ff0000">With symptoms suggesting anemia, thrombocytopenia, or infection</span>'''
* '''<span style="color:#ff0000">Coagulation studies</span>'''
** '''<span style="color:#ff0000">In the absence of clinical indications</span>''' (e.g., systemic anticoagulation, relevant hepatic dysfunction, hematologic disease or bleeding disorders, history suggestive of a coagulation disorder) '''<span style="color:#ff0000">coagulation studies should not be routinely obtained prior to surgical management of urinary stone disease</span>'''