Management of stones in calyceal diverticulum

Abstract

There is a strong trend towards endoscopical and laparoscopical treatment in renal abnormalities such as calyceal diverticula. A combination of these two methods seems to be appropriate in some cases.

Efficacy of Flexible Ureterorenoscopy with Holmium Laser in the Management of Stone-Bearing Caliceal Diverticula

“…13,[16][17][18][19][20] Our results are similar to those previously reported; the SF rate of 55.3% (success rate 81.6%) with a symptoms-free rate up to 90%. Auge and colleagues 17 described difficulties in accessing the lower pole caliceal diverticula, unlike our series in which results were not affected by the diverticula location.…”

“…In addition, it has a higher rate of complications compared with F-URS. [14][15][16][17] In addition, an anteriorly located diverticulum needs a tract that goes through more renal parenchyma and, hence, there is an increased risk of significant hemorrhage; therefore, the laparoscopic approach might be indicated, despite no large series being reported.…”

Laparoscopic and Robotic Calyceal Diverticulectomy: Outcomes and Modifications of Technique

“…Treatment options consist of extracorporeal SWL, ureteroscopy, and percutaneous nephrostolithotomy, as well as laparoscopic and robotic approaches. 2,[6][7][8] In a recent comprehensive review of the literature by Waingankar et al, 2 treatment options for management of symptomatic calyceal diverticulum were reviewed, success rates for each option were obtained, and recommendations for management were given. For SWL, the percentage of patients who become symptom free at follow-up ranged from 36% to 75%, and only 8%-40% were stone-free at follow-up.…”

Renal Stones

“…82 In other renal anomalies, the number of renal units (i.e., duplex kidney), the kidney shape (horseshoe, malrotated), and the kidney location (ectopic, crossed) are associated with difficult localization, incomplete clearance, and the presence of pelviureteric junction obstruction, which in itself may hamper stone clearance. 83 Simple renal cysts and stones in polycystic kidneys are no contraindication for SWL treatment. 84 …”