In 2015, population-based studies of urinary stones gave us some insight into the changing trends in current stone treatments. Recently, Prof. Ambani from the University of Michigan, USA, presented a review of 2015 advances in this field, which was published in the latest issue of Nature Reviews Urology. Advances in technology have led to changes in the surgical treatment of urologic stones, and Oberlin et al. reviewed the American Urological Association (AUA) registry of stone cases from 2003 to 2012 and found that ureteroscopy has replaced extracorporeal shockwave lithotripsy as the mainstay of treatment for upper urinary tract stones in the United States today. This is related to the fact that young urologists undergo a large number of endoscopic procedures as part of their residency training. Percutaneous nephrolithotripsy, on the other hand, has remained stable, accounting for 4% to 5% of procedures performed during the same period. Donaldson and colleagues used meta-analysis to compare the clinical effectiveness of different treatment modalities for the management of lower pole renal stones. They analyzed 691 patients in seven randomized controlled trials and found that percutaneous nephrolithotomy and ureteroscopy had higher stone removal rates than extracorporeal shock wave lithotripsy for stones >10 mm in the lower pole of the kidney. Percutaneous nephrolithotomy had a higher stone evacuation rate than ureteroscopy and extracorporeal shock wave lithotripsy, and ureteroscopy had a better stone evacuation rate than extracorporeal shock wave lithotripsy for stones 10-20 mm2. This study provides the first evidence at the 1a level regarding the surgical treatment of lower pole renal stones. However, due to heterogeneity between studies and other factors, the authors did not assess prevalence, retreatment rates, treatment costs, and quality of life. Therefore, Omar conducted an interesting study. He administered a questionnaire to 100 patients in a stone clinic, assuming that they had an 8-mm stone in the lower pole of the kidney, and asked them what treatment they would prefer. 45% of the patients chose extracorporeal shockwave lithotripsy under conscious sedation, 32% chose ureteroscopy, and 23% chose follow-up. This study shows that patients have different trade-offs between risk and success of treatment. In 2015 the UK Health Service published the results of a randomized, double-blind study of pharmacological stone removal therapy for renal colic (SUSPEND). The study reversed the results of previous studies and meta-analyses. In this study, 1,167 patients with ureteral stones were randomized into three groups receiving tamsulosin, nifedipine, and placebo. The study found that medication for stone removal failed to benefit the patients. Although tamsulosin showed a trend toward better stone removal for stones located in the distal ureter that were larger than 5 mm in diameter compared to placebo, a statistical difference was not achieved. According to the study protocol, stone expulsion did not need to be confirmed by imaging, and the primary endpoint of observation was the need for surgical management within 4 weeks. The European Association of Urology has updated its guidelines section on metabolic assessment and prevention of recurrence in patients with kidney stones. This guideline provides a comprehensive review of the European guidelines, which are more conservative regarding the pharmacologic control of stones than the American Urological Association and American College of Physicians guidelines published in 2014. The European guidelines are easy to follow and, when used in conjunction with the U.S. guidelines, may improve outcomes for patients with kidney stones. The European guidelines recommend allopurinol for patients with uric acid stones who have hyperuricosuria greater than 4 mmol/day, whereas the U.S. guidelines recommend citrate to alkalinize the urine. Dauw analyzed more than 200,000 patients who had at least one abnormal urine metabolic test. The authors found that only 16% of patients were reviewed within the next 6 months. Even more worrisome was the fact that the review rate was 24% lower among patients who consulted a urologist than among those who consulted a family physician. In conclusion, several articles published in 2015 provide important insights into the surgical management and pharmacologic control of stones. However, more in-depth studies on the surgical management of upper urinary tract stones, pharmacologic lithotripsy, and pharmacologic control of stones are still needed.