Ureterorenoscopic Approach to the Symptomatic Caliceal Diverticulum

Retrograde intrarenal surgery in the management of symptomatic calyceal diverticular stones: a single center experience

“…It was documented that the rate of lower pole calyceal diverticula was 10-43 % in different studies [6,8,22]. Some studies described difficulties in accessing the lower pole calyceal diverticula, and retrograde treatment of such diverticula is associated with a significantly lower success rate in some patients [21,23]. Our study shows the same results; patients with calyceal diverticular stones located in low renal pole were difficult to treat with RIRS.…”

Endoscopic Management of Symptomatic Caliceal Diverticula: A Retrospective Comparison of Percutaneous Nephrolithotripsy and Ureteroscopy

“…19,20 We were not successful in managing lower pole diverticula ureteroscopically, indicating from our results and those of others that lower pole caliceal diverticular calculi may not be conducive to ureteroscopic management. 19 A combination retrograde and antegrade approach has been utilized for some patients with stone burdens .1 cm and a long infundibular neck. This combined approach has reduced operative times compared with URS monotherapy.…”

“…18 Other urologists have demonstrated slightly better results with URS as monotherapy, attaining stone-free and symptom-free status in nearly 100% of 18 patients in whom the infundibulum was identified and dilated. 19 However, access to lower pole infundibula, because of the limited URS deflection, is frequently difficult, as is identification of some diverticula in the middle and upper portion of the collecting system, thereby necessitating a second, perhaps more invasive, procedure in some patients. 19,20 We were not successful in managing lower pole diverticula ureteroscopically, indicating from our results and those of others that lower pole caliceal diverticular calculi may not be conducive to ureteroscopic management.…”

“…19 However, access to lower pole infundibula, because of the limited URS deflection, is frequently difficult, as is identification of some diverticula in the middle and upper portion of the collecting system, thereby necessitating a second, perhaps more invasive, procedure in some patients. 19,20 We were not successful in managing lower pole diverticula ureteroscopically, indicating from our results and those of others that lower pole caliceal diverticular calculi may not be conducive to ureteroscopic management. 19 A combination retrograde and antegrade approach has been utilized for some patients with stone burdens .1 cm and a long infundibular neck.…”

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

“…We were successful in managing lower pole diverticulum ureteroscopically, unlike many reports that claim that the lower pole caliceal diverticula stone may not be conducive to ureteroscopic management. 21,22 To our knowledge, this is the largest series of stone-bearing caliceal diverticula that have been managed with F-URS holmium laser with long-term follow-up to 6 months to evaluate the presence or lack of symptoms. We believe that this procedure should be proposed as first-line therapy for stonebearing diverticula with moderate stone burden.…”