BEST OF 2019: Edited by Johannes W. Vieweg and Shahrokh F. ShariatFrontiers of stone managementHiller, Spencer C.; Ghani, Khurshid R. Author Information Department of Urology, University of Michigan, Ann Arbor, Michigan, USA Correspondence to Spencer C. Hiller, MD, Department of Urology, University of Michigan, 1500 E Medical Center Dr, TC 3875 SPC 5330, Ann Arbor, MI 48109, USA. Tel: +1 734 763 8615; e-mail: [email protected] Current Opinion in Urology 30(1):p 17-23, January 2020. | DOI: 10.1097/MOU.0000000000000698 Buy Metrics Abstract Purpose of review The surgical tool-box for urinary stone disease is growing. In this review, we discuss recent developments in the surgical management of urolithiasis, with emphasis on tailoring the management to the individual patient, and attention to the quality of care. Recent findings Shockwave lithotripsy remains a popular noninvasive treatment option for patients, with new data emerging on how to improve treatment outcomes as well as its limitations. Next-generation holmium lasers are expanding the role of dusting techniques for ureteroscopy but further studies are needed to assess safety and clinical outcomes. Advances in miniaturization and patient positioning are propelling percutaneous renal stone surgery toward endoscopic combined intrarenal and simultaneous bilateral surgery for patients with complex stone disease. Summary Stone management will be increasingly personalized to the unique qualities of the patient, stone, desired outcome, and available expertise and technology. Future studies assessing the quality of stone surgery should incorporate objective metrics to better delineate the success and cost of the different techniques available. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.