Document Detail


Prospective long-term followup of patients with asymptomatic lower pole caliceal stones.
MedLine Citation:
PMID:  17509315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The intervention time of asymptomatic lower pole calculi remains controversial. In this prospective study we evaluated the natural history and progression rate of asymptomatic lower pole stones. MATERIALS AND METHODS: Patients were followed every 6 months. Computerized tomography in even years, ultrasound scan in odd years after initial visit and abdominal plain films between these visits were evaluated. The largest diameter was measured for each calculus and the cumulative diameter was calculated for cases of multiple stones. Disease progression was defined as pain experienced during followup, stone growth or the need for intervention. RESULTS: A total of 24 patients, 14 male and 10 female, were followed for a mean of 52.3 months (range 24 to 72). Of the 24 patients 3 had bilateral lower pole stones. Mean cumulative stone diameter at presentation was 8.8 mm (range 2.0 to 26.0). Progression in stone size was demonstrated in 9 of 27 renal units (33.3%) with 2 (11.1%) requiring intervention. There was no need for intervention during the first 2 years of followup. Three stones passed spontaneously without any symptoms. Pain developed in 3 patients during followup, and 2 of them passed a stone and responded to the analgesics without further treatment. None of the patients had a pyelonephritic attack during followup. CONCLUSIONS: Our results showed that observation could be considered for patients with asymptomatic lower pole stones. However, patients should be counseled about the 33% disease progression and 11% intervention rates.
Authors:
Kubilay Inci; Ahmet Sahin; Ekrem Islamoglu; Murat T Eren; Mehmet Bakkaloglu; Haluk Ozen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  177     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-18     Completed Date:  2007-07-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2189-92     Citation Subset:  AIM; IM    
Affiliation:
Faculty of Medicine, Department of Urology, Hacettepe University, Sihhiye, Ankara 06100, Turkey. kuinci@hacettepe.edu.tr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Disease Progression
Female
Follow-Up Studies
Humans
Kidney Calculi / complications*,  pathology*,  therapy
Kidney Calices*
Male
Middle Aged
Pain, Intractable / etiology
Prospective Studies
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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