Skip to main content
SpringerLink
Log in

Pelvi-calyceal height, a predictor of success when treating lower pole stones with extracorporeal shockwave lithotripsy

  • Original Paper
  • Published:
Urological Research Aims and scope Submit manuscript

Abstract

Extra corporeal shockwave lithotripsy (ESWL) is the treatment of choice for the majority of renal stones, however, it has the lowest success rate in complete clearance of stones located in the lower pole. We assess whether pelvi-calyceal height is a useful measurement in predicting successful stone clearance from the lower pole. A total of 105 patients with a solitary lower pole calculus of less than 20 mm treated with ESWL were reviewed. Stone size, location and pelvi-calyceal height were measured by intravenous urogram. Success was defined as complete stone clearance. Fifty-four patients (51.4%) had successful treatments, with the remaining 51 (48.6%) having incomplete stone clearance (including two patients in whom treatment had no effect). There was a statistically significant difference (P<0.0001) in pelvi-calyceal height between the two groups. Mean pelvi-calyceal height in patients with complete stone clearance was 15.1 mm (SD=3.9) compared with 22.9 mm (SD=5.2) for those with incomplete clearance. Pelvi-calyceal height is a useful predictor of success when treating lower pole renal stones with ESWL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Graff J, Diederichs W, Schulze H (1998) Long-term follow up in 1,003 extracorporeal shock wave lithotripsy patients. J Urol 140: 479

    Google Scholar 

  2. Lingeman JE, Siegel YI, Steele B (1994) Management of lower pole nephrolithiasis: a critical analysis. J Urol 151: 663

    CAS  PubMed  Google Scholar 

  3. Elbahnasy AM, Clayman RV, Shalhav AL, Hoenig DM, Chandhoke P, Lingeman JE, Denstedt JD, Kahn R, Assimos DG, Nakada SY (1998) Lower calyceal stone clearance after shock wave lithotripsy or ureteroscopy: the impact of lower pole radiographic anatomy. J Urol 159: 676

    Article  CAS  PubMed  Google Scholar 

  4. Sampaio FJB, Aragao AHM (1992) Inferior pole collecting system anatomy: its probable role in extracorporeal shock wave lithotripsy. J Urol 147: 322

    CAS  PubMed  Google Scholar 

  5. Knoll T, Musial A, Trojan L, Ptashnyk T, Michel MS, Alken P, Kohrmann KU (2003) Measurement of renal anatomy for prediction of lower-pole caliceal stone clearance: reproducibility of different parameters. J Endourol 17: 447

    Article  PubMed  Google Scholar 

  6. Tuckey J, Devasia A, Murthy L, Ramsden P, Thomas D (2000) Is there a simpler method for predicting lower pole stone clearance after shockwave lithotripsy than measuring infundibulopelvic angle? J Endourol 14: 475

    CAS  PubMed  Google Scholar 

  7. Keeley FXJr, Moussa SA, Smith G, Tolley DA (1999) Clearance of lower-pole stones following shock wave lithotripsy: effect of the infundibulopelvic angle. Eur Urol 36: 371

    Article  PubMed  Google Scholar 

  8. Madbouly K, Sheir KZ, Elsobky E (2001) Impact of lower pole renal anatomy on stone clearance after shock wave lithotripsy: fact or fiction? J Urol 165: 1415

    Article  CAS  PubMed  Google Scholar 

  9. Sorenson CM, Chandhoke PS (2002) Is lower pole calyceal anatomy predictive of initial treatment or re-treatment success for extracorporeal shockwave lithotripsy of primary lower pole kidney stones? J Urol 167 [Suppl]: 380

  10. Onal B, Demirkesen O, Tansu N, Kalkan M, Altintas R, Yalcin V (2004) The impact of caliceal pelvic anatomy on stone clearance after shock wave lithotripsy for pediatric lower pole stones. J Urol 172: 1082

    Article  PubMed  Google Scholar 

  11. Brownlee N, Foster M, Griffith DP, Carlton CEJr (1990) Controlled inversion therapy: an adjunct to the elimination of gravity-dependent fragments following extracorporeal shock wave lithotripsy. J Urol 143: 1096

    CAS  PubMed  Google Scholar 

  12. Pace KT, Tariq N, Dyer SJ, Weir MJ, D’A Honey RJ (2001) Mechanical percussion, inversion, and diuresis for residual lower pole fragments after shock wave lithotripsy: a prospective, single blind, randomized controlled trial. J Urol 166: 2065

    Article  CAS  PubMed  Google Scholar 

  13. Dretler SP, Spencer BA (2001) CT and stone fragility. J Endourol 15: 31

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Stone Unit, Institute of Urology, University College London, London W1W 7EY, UK

    A. Symes, G. Shaw, D. Corry & S. Choong

Authors
  1. A. Symes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Shaw
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Corry
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Choong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Symes.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Symes, A., Shaw, G., Corry, D. et al. Pelvi-calyceal height, a predictor of success when treating lower pole stones with extracorporeal shockwave lithotripsy. Urol Res 33, 297–300 (2005). https://doi.org/10.1007/s00240-005-0476-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-005-0476-4

Keywords

Search

Navigation