Which preventive measure is recommended for patients with ureterolithiasis to reduce stone recurrence?

• A. Drink more fluids totaling 2+ liters per day
• B. Avoid any exercise
• C. Increase dietary calcium to excess
• D. Limit water intake

Answer: (A)

Maintaining high urine volume through increased fluid intake is the key preventive measure to reduce stone recurrence. Drinking enough fluids to produce a daily urine output of about 2 liters or more dilutes the urine, lowering the concentration of stone-forming minerals such as calcium, oxalate, and uric acid. This decreases the likelihood of crystallization and crystal growth, helping to flush any potential crystals from the urinary tract before they become stones. Other options either don’t affect stone risk or, in some cases, could worsen it (for example, limiting fluids increases concentration of stone-forming substances). Thus, aiming for more than 2 liters of fluids daily is the most effective general prevention strategy.