Document Detail

Small caliceal stones: what is the best method of treatment?
MedLine Citation:
PMID:  2795747     Owner:  NLM     Status:  MEDLINE    
In a retrospective analysis classical radial nephrolithotomy, percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy for symptomatic small nonobstructive caliceal stones were compared to evaluate morbidity. Size (less than 1 cm.) and location of the stone (caliceal and nonobstructive) did not explain the severity of the symptoms nor would they have been an indication for an operation. In 8 patients treated by an open operation, 16 treated percutaneously and 6 who underwent extracorporeal shock wave lithotripsy the procedure time, success rate, complication rate and length of hospitalization were analyzed. Followup consisted of ultrasound and/or a plain film of the kidneys, ureters and bladder 1 day and 3 months postoperatively. A nephrotomogram was included in group 3 patients. Of 30 patients 3 had persistent stone fragments for more than 3 months: 2 underwent percutaneous nephrolithotomy and 1 was treated by extracorporeal shock wave lithotripsy. A total of 28 patients (93.3 per cent) achieved complete or significant relief of pain. In the percutaneous group both patients with persistent fragments were symptomatic in contrast with the extracorporeal shock wave lithotripsy group, in which 1 patient presented with stone fragments but was free of pain. The group treated percutaneously had a shorter procedure time (60 minutes) and the shock wave group had a shorter hospitalization. On the other hand, the open operation group had a better success rate as well as relief of pain. These observations showed that small, nonobstructive caliceal stones can be responsible for persistent, severe flank pain. Since extracorporeal shock wave lithotripsy is an effective noninvasive procedure that does not require routine anesthesia and hospitalization, with prompt return of the patient to normal life, it must be considered the method of choice in these particular patients.
N R Netto Júnior; J F Claro; U Ferreira; G C Lemos
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  142     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  1989 Oct 
Date Detail:
Created Date:  1989-10-31     Completed Date:  1989-10-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  941-2     Citation Subset:  AIM; IM    
Division of Urology, University of Campinas Medical Center, Sao Paulo, Brazil.
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MeSH Terms
Evaluation Studies as Topic
Kidney Calculi / physiopathology,  surgery,  therapy*
Middle Aged
Nephrons / surgery
Pain / therapy
Particle Size
Retrospective Studies

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