Prospective Long-Term Followup of Patients With Asymptomatic Lower Pole Caliceal Stones
2007; Lippincott Williams & Wilkins; Volume: 177; Issue: 6 Linguagem: Inglês
10.1016/j.juro.2007.01.154
ISSN1527-3792
AutoresKubilay İnci, Ahmet Şahin, Ekrem İslamoğlu, Murat Tuğrul Eren, Mehmet Bakkaloğlu, Haluk Özen,
Tópico(s)Genital Health and Disease
ResumoNo AccessJournal of UrologyAdult urology1 Jun 2007Prospective Long-Term Followup of Patients With Asymptomatic Lower Pole Caliceal Stones Kubilay Inci, Ahmet Sahin, Ekrem Islamoglu, Murat T. Eren, Mehmet Bakkaloglu, and Haluk Ozen Kubilay InciKubilay Inci More articles by this author , Ahmet SahinAhmet Sahin More articles by this author , Ekrem IslamogluEkrem Islamoglu More articles by this author , Murat T. ErenMurat T. Eren More articles by this author , Mehmet BakkalogluMehmet Bakkaloglu More articles by this author , and Haluk OzenHaluk Ozen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.01.154AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The intervention time of asymptomatic lower pole calculi remains controversial. In this prospective study we evaluated the natural history and progression rate of asymptomatic lower pole stones. Materials and Methods: Patients were followed every 6 months. Computerized tomography in even years, ultrasound scan in odd years after initial visit and abdominal plain films between these visits were evaluated. The largest diameter was measured for each calculus and the cumulative diameter was calculated for cases of multiple stones. Disease progression was defined as pain experienced during followup, stone growth or the need for intervention. Results: A total of 24 patients, 14 male and 10 female, were followed for a mean of 52.3 months (range 24 to 72). Of the 24 patients 3 had bilateral lower pole stones. Mean cumulative stone diameter at presentation was 8.8 mm (range 2.0 to 26.0). Progression in stone size was demonstrated in 9 of 27 renal units (33.3%) with 2 (11.1%) requiring intervention. There was no need for intervention during the first 2 years of followup. Three stones passed spontaneously without any symptoms. Pain developed in 3 patients during followup, and 2 of them passed a stone and responded to the analgesics without further treatment. None of the patients had a pyelonephritic attack during followup. Conclusions: Our results showed that observation could be considered for patients with asymptomatic lower pole stones. However, patients should be counseled about the 33% disease progression and 11% intervention rates. References 1 : Small renal caliceal calculi as a cause of pain. J Urol1983; 130: 752. Link, Google Scholar 2 : Painful caliceal calculi: The treatment of small nonobstructing caliceal calculi in patients with symptoms. Scand J Urol Nephrol1993; 27: 75. Google Scholar 3 : Small caliceal stones: is extracorporeal shock wave lithotripsy justified?. J Urol1988; 139: 908. Link, Google Scholar 4 : The natural history of asymptomatic urolithiasis. J Urol1992; 147: 319. 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Google Scholar Faculty of Medicine, Department of Urology, Hacettepe University, Ankara, Turkey© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byAssimos D (2018) Re: Super-Mini Percutaneous Nephrolithotomy (SMP) vs Retrograde Intrarenal Surgery for the Treatment of 1-2 cm Lower-Pole Renal Calculi: An International Multicentre Randomised Controlled TrialJournal of Urology, VOL. 201, NO. 1, (24-24), Online publication date: 1-Jan-2019.Dos Santos J, Lopes R, Veloso A, Harvey E, Farhat W and Papanikolaou F (2016) Outcome Analysis of Asymptomatic Lower Pole Stones in ChildrenJournal of Urology, VOL. 195, NO. 4 Part 2, (1289-1293), Online publication date: 1-Apr-2016.Dropkin B, Moses R, Sharma D and Pais V (2014) The Natural History of Nonobstructing Asymptomatic Renal Stones Managed with Active SurveillanceJournal of Urology, VOL. 193, NO. 4, (1265-1269), Online publication date: 1-Apr-2015.Kang H, Lee S, Kim W, Kim Y, Yun S, Lee S and Kim W (2012) Natural History of Asymptomatic Renal Stones and Prediction of Stone Related EventsJournal of Urology, VOL. 189, NO. 5, (1740-1746), Online publication date: 1-May-2013.Yuruk E, Binbay M, Sari E, Akman T, Altinyay E, Baykal M, Muslumanoglu A and Tefekli A (2010) A Prospective, Randomized Trial of Management for Asymptomatic Lower Pole CalculiJournal of Urology, VOL. 183, NO. 4, (1424-1428), Online publication date: 1-Apr-2010.Schenkman N (2018) Commentary on Shock Wave Lithotripsy Versus Ureteroscopy for Lower Pole Caliceal CalculiJournal of Urology, VOL. 179, NO. 5S, (S74-S74), Online publication date: 1-May-2008. Volume 177Issue 6June 2007Page: 2189-2192 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordssigns and symptomsurinary calculiobservationMetrics Author Information Kubilay Inci More articles by this author Ahmet Sahin More articles by this author Ekrem Islamoglu More articles by this author Murat T. Eren More articles by this author Mehmet Bakkaloglu More articles by this author Haluk Ozen More articles by this author Expand All Advertisement PDF downloadLoading ...
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