Document Detail

Radiographic anatomical factors do not predict clearance of lower caliceal calculus by shock-wave lithotripsy.
MedLine Citation:
PMID:  16118095     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Use of shock-wave lithotripsy (SWL) for lower caliceal calculus is associated with a relatively high rate of residual fragments. Various radiographic anatomical factors of the lower calix predicting the outcome of lithotripsy have been described and have generated considerable discussion. We aimed to reassess the role of these factors in predicting clearance of lower caliceal stones by SWL. MATERIAL AND METHODS: Between January 1998 and December 2001, 148 patients underwent SWL for solitary lower caliceal stones using a Dornier Compact S lithotripter. The infundibular length, infundibular width, caliceopelvic height and infundibulopelvic angle were measured. Success was defined as either complete clearance or clearance with insignificant residual fragments <4 mm in size at 3 months follow-up. The results were analysed using the chi2 test and logistic regression analysis. RESULTS: Complete clearance was seen in 69% of cases and clearance with residual fragments <4 mm in size at 3 months was seen in 5%. The overall clearance rate at 3 months was 74%. Infundibular length, infundibular width, caliceopelvic height and stone size were not found to be statistically significant in predicting clearance. None of the patients had an infundibulopelvic angle of >90 degrees. Contrary to most previous studies, univariate and multivariate analysis revealed that an infundibulopelvic angle of <70 degrees was statistically significant in predicting clearance in the stone-free group. CONCLUSIONS: The use of radiographic anatomical factors to predict clearance of lower caliceal stones following SWL is an attractive concept. However, based on this study, we feel that these factors do not merit the attention they have attracted. In routine practice, regardless of the radiological anatomy, SWL continues to be the initial treatment option, given its non-invasive nature and ease of administration.
Bobby Viswaroop; Antony Devasia; Lionel Gnanaraj; Ninan Chacko; Nitin Kekre; Ganesh Gopalakrishnan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of urology and nephrology     Volume:  39     ISSN:  0036-5599     ISO Abbreviation:  Scand. J. Urol. Nephrol.     Publication Date:  2005  
Date Detail:
Created Date:  2005-08-24     Completed Date:  2005-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0114501     Medline TA:  Scand J Urol Nephrol     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  226-9     Citation Subset:  IM    
Department of Urology, Christian Medical College, Vellore, India.
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MeSH Terms
Follow-Up Studies
Hospitals, Public
Kidney Calculi / radiography*,  therapy*
Kidney Calices / radiography*
Middle Aged
Predictive Value of Tests
Retrospective Studies
Treatment Outcome
Ureter / radiography

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

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