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Is Lower Pole Caliceal Anatomy Predictive of Extracorporeal Shock Wave Lithotripsy Success for Primary Lower Pole Kidney Stones?

2002; Lippincott Williams & Wilkins; Volume: 168; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(05)64149-3

1527-3792

CARSTEN M. SORENSEN, Paramjit S. Chandhoke,

Traumatic Ocular and Foreign Body Injuries

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Dec 2002Is Lower Pole Caliceal Anatomy Predictive of Extracorporeal Shock Wave Lithotripsy Success for Primary Lower Pole Kidney Stones? CARSTEN M. SORENSEN and PARAMJIT S. CHANDHOKE CARSTEN M. SORENSENCARSTEN M. SORENSEN and PARAMJIT S. CHANDHOKEPARAMJIT S. CHANDHOKE View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64149-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The management of lower pole kidney stones is controversial. We examined whether lower pole caliceal anatomy could predict the success of extracorporeal shock wave lithotripsy of primary lower pole kidney stones 20 mm. or less. Materials and Methods: From December 1997 to June 2001, 246 adults with a single, 20 mm. or less radiopaque lower pole renal stone were treated with the Doli 50 lithotriptor (Dornier Medical Systems, Marietta, Georgia) while under general anesthesia. Of the 246 patients 190 (77%) had excretory urography available for review. Lower pole infundibular length and width, lower pole infundibulopelvic angle and caliceal-pelvic height were measurable on 161 (85%), 129 (68%), 128 (67%) and 163 (86%) excretory urograms, respectively. Extracorporeal shock wave lithotripsy was considered a failure if residual stone fragments remained after 1 month, or an auxiliary procedure or re-treatment was required. Results: The overall stone-free rate was 78% (32 of 41) for stones 5 mm. or less, 73% (98 of 135) for stones 6 to 10 mm., 43% (22 of 51) for stones 11 to 15 mm. and 30% (7 of 19) for stones 16 to 20 mm. in maximum linear dimension. The stone-free rates grouped according to stone surface area were 76% (48 of 63 stones) for stone surface area 25 mm.2 or less, 69% (97 of 141) for 26 to 100 mm.2 and 33% (14 of 42) for 101 to 400 mm.2. Caliceal anatomy was not predictive of success even with stones grouped as 10 or less or 11 to 20 mm. Grouping patients with favorable (lower pole infundibulopelvic angle 70 degrees or greater, lower pole infundibular length 30 mm. or less and lower pole infundibular width greater than 5 mm.) versus unfavorable (70 degrees or less, greater than 30 mm. and 5 mm. or less, respectively) anatomy was also not predictive of success. Conclusions: On the Doli 50 machine stone size rather than caliceal anatomy is predictive of treatment outcome. Initial treatment failures with this machine should be managed by alternative endoscopic procedures if necessary rather than by repeat shock wave lithotripsy. References 1 : Management of calyceal calculi. Urol Clin North Am1997; 24: 81. 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Volume 168Issue 6December 2002Page: 2377-2382 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordskidney calculianatomylithotripsykidney caliceskidneyMetricsAuthor Information CARSTEN M. SORENSEN More articles by this author PARAMJIT S. CHANDHOKE More articles by this author Expand All Advertisement PDF downloadLoading ...