Effect of parathyroidectomy on stone recurrence in primary hyperparathyroidism

The use of PTX significantly reduces the long-term risk of stone recurrence but does not eliminate it entirely. In patients with a history of nephrolithiasis, short-term risk may be elevated after PTX but declines markedly over time. Individualized follow-up including regular assessment of serum calcium, parathyroid hormone, renal function, and 24‑h urinary parameters, together with preventive measures where indicated, such as adequate fluid intake, dietary counselling, potassium citrate or thiazide therapy, is recommended, particularly in patients with persistent risk factors. Decisions regarding surgical treatment of existing kidney stones should be individualized based on stone size, location, symptoms, infection risk as well as the overall patient risk profile and life expectancy.