Slide 1: Q: Asymptomatic kidney stones in which patients should be treated for the purposes of employment?

Slide 2: A: Military pilots!

Slide 3: Most asymptomatic kidney stones do not eventually lead to symptoms and only a minority eventually require surgical intervention. The American Urologic ASsociation (AUA) deems it appropriate to take a watch-and-wait approach to asymptomatic kidney stones, even in children.

Slide 4: However, some jobs are considered high risk if a stone were to become symptomatic. This mainly applies to pilots in whom symptomatic nephrolithiasis may jeopardize a flight. For the US Air Force and US Army aircrew, nephrolithiasis, whether symptomatic or not, is a disqualification. The Federal Aviation Administration (FAA) is more lenient and grants waivers for asymptomatic stones depending on their size, location, and rate of growth. In fact, there are currently over 17,000 pilots with the diagnosis of nephrolithiasis in the FAA registry.