Abstract
Technical developments and patient requests for rapid stone removal have led to changes in clinical stone management. Treatment shifted from open to percutaneous surgery, which was then almost replaced by shock wave lithotripsy (SWL). During the last decade, limitations of SWL in some situations became evident, and with the technical improvements of endoscopy and lithotripsy modalities, ureteroscopy (URS) became more than an adjunct to the available procedures. Today, the whole portfolio of minimal-invasive techniques is used, based on an individualized tailored decision tree. Patient-specific parameters such as stone composition or anatomy are important aspects to be considered apart from stone size and localization. The demand for imperative complete stone removal has led to a clear shift toward endourology, even though SWL remains an effective treatment for far the most stone situations. This is underlined by data supporting preventive stone management because of significant rate of symptomatic episodes during surveillance. This chapter discusses indications for active treatment and proposes algorithms for choosing the proper procedure considering all treatment options from SWL, ureterorenoscopy (URS), percutaneous nephrolithotomy (PNL), and open or laparoscopic techniques.
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References
Al-Awadi KA, Abdul Halim H, Kehinde EO et al (1999) Steinstrasse: a comparison of incidence with and without J stenting and the effect of J stenting on subsequent management. BJU Int 84(6):618–621, http://www.ncbi.nlm.nih.gov/pubmed/10510104
Albala DM, Assimos DG, Clayman RV, Denstedt JD, Grasso M, Gutierrez-Aceves J, Kahn RI, Leveillee RJ, Lingeman JE, Macaluso JN Jr, Munch LC, Nakada SY, Newman RC, Pearle MS, Preminger GM, Teichman J, Woods JR (2001) Lower pole I: a prospective randomized trial of shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis-initial results. J Urol 166(6):2072–2080
Albanis S, Ather HM, Papatsoris AG et al (2009) Inversion, hydration and diuresis during shock wave lithotripsy: does it improve the stone-free rate for lower pole stone clearance? Urol Int 83(2):211–216, http://www.ncbi.nlm.nih.gov/pubmed/19752619
Andersson L, Sylven M (1983) Small renal caliceal calculi as a cause of pain. J Urol 130(4):752–753, http://www.ncbi.nlm.nih.gov/pubmed/6887409
Argyropoulos AN, Tolley DA (2010) Evaluation of outcome following lithotripsy. Curr Opin Urol 20(2):154–158, http://www.ncbi.nlm.nih.gov/pubmed/19898239
Brandt B, Ostri P, Lange P et al (1993) Painful caliceal calculi. The treatment of small nonobstructingcaliceal calculi in patients with symptoms. Scand J Urol Nephrol 27(1):75–76, http://www.ncbi.nlm.nih.gov/pubmed/8493473
Breda A, Ogunyemi O, Leppert JT, Lam JS, Schulam PG (2008) Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater – is this the new frontier? J Urol 179(3):981–984, Epub 2008 Jan 22. PubMed PMID: 18207179
Burgher A, Beman M, Holtzman JL et al (2004) Progression of nephrolithiasis: long-term outcomes with observation of asymptomatic calculi. J Endourol 18(6):534–539, http://www.ncbi.nlm.nih.gov/pubmed/15333216
Collins JW, Keeley FX (2002) Is there a role for prophylactic shock wave lithotripsy for asymptomatic calyceal stones? Curr Opin Urol 12(4):281–286, http://www.ncbi.nlm.nih.gov/pubmed/12072647
Geavlete P, Georgescu D, Niţă G, Mirciulescu V, Cauni V (2006) Complications of 2735 retrograde semirigid ureteroscopy procedures: a single-center experience. J Endourol 20(3):179–185, PubMed PMID: 16548724
Glowacki LS, Beecroft ML, Cook RJ et al (1992) The natural history of asymptomatic urolithiasis. J Urol 147(2):319–321, http://www.ncbi.nlm.nih.gov/pubmed/1732583
Goel R, Aron M, Kesarwani PK et al (2005) Percutaneous antegrade removal of impacted upper-ureteral calculi: still the treatment of choice in developing countries. J Endourol 19(1):54–57, http://www.ncbi.nlm.nih.gov/pubmed/15735384
Goyal R, Dubey D, Khurana N et al (2006) Does the type of steinstrasse predict the outcome of expectant therapy? Indian J Urol 22(2):135–138
Hubner W, Porpaczy P (1990) Treatment of caliceal calculi. Br J Urol 66(1):9–11, http://www.ncbi.nlm.nih.gov/pubmed/2393803
Hyams ES, Munver R, Bird VG, Uberoi J, Shah O (2010) Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm: a multi-institutional experience. J Endourol 24(10):1583–1588, PubMed PMID: 20629566
Inci K, Sahin A, Islamoglu E et al (2007) Prospective long-term followup of patients with asymptomatic lower pole caliceal stones. J Urol 177(6):2189–2192, http://www.ncbi.nlm.nih.gov/pubmed/17509315
Keeley FX Jr, Tilling K, Elves A et al (2001) Preliminary results of a randomized controlled trial of prophylactic shock wave lithotripsy for small asymptomatic renal calyceal stones. BJU Int 87(1):1–8, http://www.ncbi.nlm.nih.gov/pubmed/11121982
Klingler HC, Kramer G, Lodde M et al (2003) Stone treatment and coagulopathy. Eur Urol 43(1):75–79, http://www.ncbi.nlm.nih.gov/pubmed/12507547
Kosar A, Ozturk A, Serel TA et al (1999) Effect of vibration massage therapy after extracorporeal shockwave lithotripsy in patients with lower caliceal stones. J Endourol 13(10):705–707, http://www.ncbi.nlm.nih.gov/pubmed/10646674
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(5):1415–1418, http://www.ncbi.nlm.nih.gov/pubmed/11342888
Madbouly K, Sheir KZ, Elsobky E et al (2002) Risk factors for the formation of a steinstrasse after shock wave lithotripsy: a statistical model. J Urol 167(3):1239–1242, http://www.ncbi.nlm.nih.gov/pubmed/11832705
Manikandan R, Gall Z, Gunendran T et al (2007) Do anatomic factors pose a significant risk in the formation of lower pole stones? Urology 69(4):620–624, http://www.ncbi.nlm.nih.gov/pubmed/18468660
Mee SL, Thuroff JW (1988) Small caliceal stones: is shock wave lithotripsy justified? J Urol 139(5):908–910, http://www.ncbi.nlm.nih.gov/pubmed/3361660
Pearle MS, Lingeman JE, Leveillee R et al (2005) Prospective, randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. J Urol. 173(6):2005– 2009, PubMed PMID: 15879805
Preminger GM (2006) Management of lower pole renal calculi: shock wave lithotripsy versus percutaneous nephrolithotomy versus flexible ureteroscopy. Urol Res 34(2):108–111, http://www.ncbi.nlm.nih.gov/pubmed/16463145
Preminger GM, Tiselius HG, Assimos DG et al (2007) Guideline for the management of ureteral calculi. Eur Urol 52(6):1610–1631, http://www.ncbi.nlm.nih.gov/pubmed/18074433
Resim S, Ekerbicer HC, Ciftci A (2005) Role of tamsulosin in treatment of patients with steinstrasse developing after shock wave lithotripsy. Urology 66(5):945–948, http://www.ncbi.nlm.nih.gov/pubmed/16286100
Sayed MA, el-Taher AM, Aboul-Ella HA et al (2001) Steinstrasse after extracorporeal shockwave lithotripsy: aetiology, prevention and management. BJU Int 88(7):675–678, http://www.ncbi.nlm.nih.gov/pubmed/11890235
Srisubat A, Potisat S, Lojanapiwat B et al (2009) shock wave lithotripsy (SWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones. Cochrane Database Syst Rev (4):CD007044 http://www.ncbi.nlm.nih.gov/pubmed/19821393
Sumino Y, Mimata H, Tasaki Y et al (2002) Predictors of lower pole renal stone clearance after shock wave lithotripsy. J Urol 168(4 Pt 1):1344–1347, http://www.ncbi.nlm.nih.gov/pubmed/12352389
Sun X, Xia S, Lu J et al (2008) Treatment of large impacted proximal ureteral stones: randomized comparison of percutaneous antegrade ureterolithotripsy versus retrograde ureterolithotripsy. J Endourol 22(5):913–917, http://www.ncbi.nlm.nih.gov/pubmed/18429682
Tiselius HG (2008) How efficient is extracorporeal shockwave lithotripsy with modern lithotripters for removal of ureteral stones? J Endourol 22(2):249–255, http://www.ncbi.nlm.nih.gov/pubmed/18294029
Tolley DA (1993) Consensus of lithotriptor terminology. World J Urol 11(1):37–42, http://www.ncbi.nlm.nih.gov/pubmed/8490666
Türk C, Knoll T, Petric A, Sarica K, Seitz C, Straub M, members of the European Association of Urology (EAU) Guidelines Office (2011) Guidelines on urolithiasis. In: EAU guidelines, edition presented at the 26th EAU Annual Congress, Vienna, 2011. ISBN 978–90–79754–70–0 http://www.uroweb.org/guidelines/online-guidelines
Watterson JD, Girvan AR, Cook AJ et al (2002) Safety and efficacy of holmium:YAG laser lithotripsy in patients with bleeding diatheses. J Urol 168(2):442–445, http://www.ncbi.nlm.nih.gov/pubmed/12131284
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Knoll, T., Pearle, M.S. (2013). Indications for Active Treatment and Procedure Selection. In: Knoll, T., Pearle, M. (eds) Clinical Management of Urolithiasis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28732-9_5
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DOI: https://doi.org/10.1007/978-3-642-28732-9_5
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