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Shock-wave lithotripsy for lower calyceal stones 1to2 centimetres in size - Out-dated or still standard of care

VENKATRAMANI VIVEK

Abstract


Introduction - Shock-wave lithotripsy is
the traditional treatment for lower calyceal
stones 1-2cm in size however newer
options are emerging. We performed this
study to determine the efficacy of lithotripsy
in this category of patients and to
determine whether anatomical factors
played any role. Methods - All adult patients
with solitary lower calyceal stones
1-2cm in size undergoing lithotripsy in
the calendar year 2012 were included.
Success was defined as complete clearance
or presence of clinically insignificant
residual fragments 4mm. Anatomic
factors studied were calyceal length, infundibular
width, indundibulo-pelvic angle
and presence of compound calyces. Results
- A total of 37 cases were included.
Overall success rate was 64.8percent at
4 weeks with over half achieving complete
clearance. Effectiveness quotient
was 35.1percent. There was no significant
effect of anatomical factors and only
3 patients required ancillary procedures.
Conclusion -
Lithotripsy remains a safe and effective option
for this class of patients. Anatomical
factors did not predict clearance in our
study.


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