Renal pelvic stones: choosing shock wave lithotripsy or percutaneous nephrolithotomy

Abstract

Introduction of minimally invasive techniques has revolutionized the surgical management of renal calculi. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy are now both well-established procedures. Each modality has advantages and disadvantages, and the application of each should be based on well-defined factors. These variables include stone factors such as number, size, and composition; factors related to the stone's environment, including the stone's location, spatial anatomy of the renal collecting system, presence of hydronephrosis, and other anatomic variables, such as the presence of calyceal diverticula and renal anomalies; and clinical or patient factors like morbid obesity, the presence of a solitary kidney, and renal insufficiency. The morbidity of each procedure in relation to its efficacy should be taken in to account. This article will review current knowledge and suggest an algorithm for the rational management of renal calculi with shock wave lithotripsy and percutaneous nephrolithotomy.

Study of quality of life and its determinants in patients after urinary stone fragmentation

“…Extracorporeal shock-wave lithotripsy (ESWL), ureteroscopy (flexible and semirigid) with intracorporeal lithotripsy (URS) and percutaneous nephrolithotripsy (PCNL) are well-established procedures for fragmentation of stones using a lithotriptor. Each modality is associated with advantages and disadvantages, and the choice of modality should be based on well-defined factors, including the type of stone, its location and environment, and other anatomic characteristics [3]. The high prevalence of recurrent stone formation, which in turn is associated with increased morbidity and hospitalization, suggests that stone disease could be a serious health problem that has a significant effect on patients' quality of life (QOL) [1,2,4].…”

Alternative management of complex renal stones

“…Obese patients may be too large for the SWL table, and the distance to the stone may be longer than the lithotripter's focal length. Larger patients have demonstrated a decreased chance of success with SWL with body mass index (BMI) as a variable having been found to be an independent predictor of success [14].…”

Is Postoperative Routine Thoracic Imaging Necessary to Detect Thoracic Complications in Patients Undergoing Supracostal Mini Percutaneous Nephrolithotomy (M-pcnl) Surgery?

“…Percutaneous nephrolithotomy (PCNL), exible ureterorenoscopy (f-URS), extracorporeal shock wave lithotripsy (ESWL), open and laparoscopic surgery are the methods used in the treatment of kidney stones. Factors affecting treatment selection can be listed as stone characteristics (stone size, stone localization, stone structure), kidney anatomy, patient characteristics (obesity, solitary kidney) and surgeon opinion (2). Percutaneous nephrolithotomy surgery is the gold standard treatment method for kidney stones larger than 2 cm in the current guideline of the European Association of Urology (EAU) (3).…”