Percutaneous Nephrolithotomy (PCNL) for Calyceal Diverticulum: An Egyptian Experience

  • Ahmed Mohamed Elshal
  • Ahmed M. Shoma
  • Ahmed A. Shokeir
Chapter
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Abstract

Stone in a calyceal diverticulum is rarely symptomatic. Percutaneous management is considered the treatment of choice. However, many challenges may face the endourologist. To overcome difficulties in puncture creation, opacification of the diverticulum by IVU or retrograde, direct puncture over the stone and US- or CT-guided puncture could be helpful. Careful track dilatation (balloon is advisable) to avoid overdilatation is important. Effort should be paid to visualize the neck of the diverticulum. Otherwise, creation of neoinfundibulotomy may be the choice to ensure drainage of the diverticulum to the pelvicalyceal system. Fulguration of the diverticular cavity could be an easier way at the conclusion of the procedure with a draining calycostomy tube for 1–2 days. Expertise in percutaneous, ureteroscopic, and laparoscopic techniques provides the urologist with the best opportunity to individualize treatment approach based on location and size of the diverticulum and stone. In conclusion, high success rate could be achieved in treating calyceal diverticular stone with PCNL using stepwise approach. We provided a treatment algorithm which could be helpful in patient counseling and decision-making.

Keywords

Renal Pelvis Indigo Carmine Nephrostomy Tube Stone Burden Direct Puncture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Ahmed Mohamed Elshal
    • 1
  • Ahmed M. Shoma
    • 1
  • Ahmed A. Shokeir
    • 1
  1. 1.Department of UrologyUrology and Nephrology Center, Mansoura UniversityMansouraEgypt

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