Good question! And in general, No. Most often, calcium oxalate stones are a mixture of these two stone types; it is unusual they are purely one or the other. However, if I see a pure monohydrate stone, I look harder for the various types of enteric hyperoxaluria: bariatric surgery of the small bowel...

I manage calcium oxalate monohydrate and calcium oxalate dihydrate stones the same way. Based on my laboratory studies of calcium oxalate crystallization, the differentiating feature between these two stone types is likely related to differing inhibitor properties of urinary proteins; forming the di...