Anatomical factors predicting lower calyceal stone clearance after extracorporeal shockwave lithotripsy

Khan, Mohammad; Lal, Murli; Kash, Deep Par; Hussain, Mudassir; Rizvi, Syed Adib-ul-Hasan

doi:10.1016/j.afju.2015.09.006

Cited by 6 publications

(6 citation statements)

References 27 publications

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“…Lower calyceal stones have a poorer clearance rate as compared to renal pelvic, upper, and mid calyceal stones (52). Lower calyceal stone clearance by ESWL is dependent on anatomical factors such as lower calyceal infundibular width, length, and infundibulopelvic angle (53, 54).…”

Section: Extracorporeal Shockwave Lithotripsymentioning

confidence: 99%

Update on Surgical Management of Pediatric Urolithiasis

et al. 2019

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Urolithiasis has always been a fascinating disease, even more so in children. There are many intriguing facets to this pathology. This article is a nonsystematic review to provide an update on the surgical management of pediatric urolithiasis. It highlights the pros and cons of various minimally invasive surgical options such as extracorporeal shockwave lithotripsy (ESWL), retrograde intrarenal surgery (RIRS), percutaneous nephrolithotomy (PCNL), laparoscopy, and robotics. This article also describes the various intracorporeal disintegration technologies available to fragment the stone, including the newer advancements in laser technology. It also emphasizes the cost considerations especially with reference to the emerging economies. Thus, this manuscript guides how to select the least-invasive option for an individual patient, considering age and gender; stone size, location, and composition; and facilities and expertise available.

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Section: Extracorporeal Shockwave Lithotripsymentioning

confidence: 99%

Update on Surgical Management of Pediatric Urolithiasis

et al. 2019

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“…In addition, it has a lower chance of success for cystine stones, lower pole stones, and stones larger than 2 cm. [ 3 4 ] With the development of the flexible endoscope and laser technology, retrograde intrarenal surgery (RIRS) may be applied to upper urinary tract stones with high success and low complication rates. After an initial experience in adult population, RIRS has also been successfully used for the pediatric age group.…”

Section: Introductionmentioning

confidence: 99%

“…reported that the application rate of SWL remained stable, while RIRS increased from 15% to 31% in the period between 2007 and 2014. [ 4 5 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of extracorporeal shockwave lithotripsy and retrograde intrarenal surgery in the treatment of renal pelvic and proximal ureteral stones ≤2 cm in children

Güler

Erbin

2020

Indian J Urol

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Introduction: We aimed to compare extracorporeal shockwave lithotripsy (ESWL) and retrograde intrarenal surgery (RIRS) in pediatric patients with ≤2 cm renal pelvis and proximal ureteral stones. Methods: Medical records of 165 pediatric patients who underwent shockwave lithotripsy (SWL) or RIRS for upper urinary system stones up to 2 cm between January 2014 and December 2018 were retrospectively reviewed. After exclusions, the remaining 130 patients included 73 in the SWL group and 57 in the RIRS group. The groups were compared for demographic features, stone characteristics, operative data, success, and complications. Results: The mean stone volume was 308 ± 85 (54–800) and 336 ± 96 (60–720) mm 3 in SWL and RIRS groups, respectively ( P = 0.46). There were no significant differences in success rates (60% vs. 70%, SWL and RIRS), auxiliary treatment rates (16.4% vs. 14%), and complication rates (26% vs. 24.5%). The number of active procedural sessions and number of anesthesia sessions was higher in the RIRS group ( P < 0.001 and P < 0.001, respectively), while the procedural time and anesthesia time were higher in the SWL group ( P < 0.001 and P < 0.001, respectively). Stone size was found to be an independent success predictive factor for both the treatment modalities. Conclusions: Both SWL and RIRS have similar success, complication, and auxiliary treatment rates. RIRS was superior in terms of total procedure and anesthesia durations, while SWL was superior in terms of numbers of anesthesia sessions and active procedure sessions. As both have similar success rates, the more minimally invasive SWL should be chosen for pediatric upper urinary system stones of less than 2 cm size.

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“…IPA, infundibular length (IL) and infundibular width (IW) have all been described in relationship to the treatment success of SWL [11]. Although this association has been descried in RIRS for accessing the lower pole, the clinical data on treatment outcome is sparse [12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Role of pelvicalyceal anatomy in the outcomes of retrograde intrarenal surgery (RIRS) for lower pole stones: outcomes with a systematic review of literature

et al. 2019

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Controversies exist on the influence of lower pole anatomy (infundibular pelvic angle, IPA; infundibular length, IL; and infundibular width, IW) for success and outcomes related to the treatment of stones in the lower pole. We wanted to look at the role of lower pole anatomy to study clinical outcomes in patients treated for isolated lower pole stones (LPS) using retrograde intra renal surgery (RIRS), and also perform a review to look at the published literature on the influence of pelvicalyceal anatomy on success with RIRS. Data were prospectively collected (June 2013-June 2016) for all patients who underwent RIRS for LPS, and the imaging was then retrospectively reviewed to calculate the IPA, IL and IW using the Elbahnasy method. A systematic review was also conducted for all English language articles between January 2000 and April 2018, reporting on the impact of pelvicaliceal anatomy on RIRS. A total of 108 patients with LPS were included with a male to female ratio of 2:3 and a mean age of 54.7 years. The mean lower pole stone size was 9.3 mm (range 3-29 mm) and 102/108 (94.4%) patients were stone free (SF) at the end of their procedure. While steep IPA (< 30°), operative time duration and larger stone size were significant predictors of failure, the placement of ureteric access sheath, IW and IL did not influence treatment outcomes. Six studies (460 patients) met the inclusion criteria for our review. The IPA, IW, IL for failure ranged from 26° to 38°, 5.5-7 mm and 24-34 mm, respectively. The SFR ranged from 78 to 88% with a metaanalysis showing IPA as the most important predictor of treatment outcomes for LPS. Infundibular pelvic angle seems to be the most important predictor for the treatment of LPS using RIRS. Pelvicalyceal anatomy in conjunction with stone size and hardness seem to dictate the success, and decisions on the type of surgical interventions should reflect this.

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Anatomical factors predicting lower calyceal stone clearance after extracorporeal shockwave lithotripsy

Cited by 6 publications

References 27 publications

Update on Surgical Management of Pediatric Urolithiasis

Update on Surgical Management of Pediatric Urolithiasis

Comparison of extracorporeal shockwave lithotripsy and retrograde intrarenal surgery in the treatment of renal pelvic and proximal ureteral stones ≤2 cm in children

Role of pelvicalyceal anatomy in the outcomes of retrograde intrarenal surgery (RIRS) for lower pole stones: outcomes with a systematic review of literature

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