Cargando…

Extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter

Extracorporeal shockwave lithotripsy (ESWL) has revolutionized the treatment of urinary calculi and became the accepted standard therapy for the majority of stone patients. Only for stones located in the lower calix, ESWL displayed a limited efficacy. Since the stone-free rate seemed to be preferent...

Descripción completa

Detalles Bibliográficos
Autores principales: Chaussy, Christian, Bergsdorf, Thorsten
Formato: Texto
Lenguaje:English
Publicado: Medknow Publications 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684396/
https://www.ncbi.nlm.nih.gov/pubmed/19468510
http://dx.doi.org/10.4103/0970-1591.44260
_version_ 1782167221433270272
author Chaussy, Christian
Bergsdorf, Thorsten
author_facet Chaussy, Christian
Bergsdorf, Thorsten
author_sort Chaussy, Christian
collection PubMed
description Extracorporeal shockwave lithotripsy (ESWL) has revolutionized the treatment of urinary calculi and became the accepted standard therapy for the majority of stone patients. Only for stones located in the lower calix, ESWL displayed a limited efficacy. Since the stone-free rate seemed to be preferential, endoscopic maneuvers like percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) have been proposed as the primary approach for this stone localization. Stone size seems to be the most important parameter in regard to the stone-free rate, whereas anatomical characteristics of the lower pole collecting system are discussed controversial. Various studies show a good stone clearance between 70-84% for stones up to 1 cm in diameter. Additional physical and medical measures are suitable to improve treatment results. Stone remnants after ESWL, defined as clinical insignificant residual fragments (CIRF) will not cause problems in every case and will pass until up to 24 months after treatment; in total 80-90% of all patients will become stone-free or at least symptom-free. When complete stone-free status is the primary goal, follow-up examinations with new radiological technologies like spiral CT show that the stone-free rate of ESWL and endoscopically treated patients (RIRS) does not differ significantly. However, in comparison to endoscopic stone removal, shockwave therapy is noninvasive, anesthesia-free and can be performed in an outpatient setup. Therefore, ESWL remains the first choice option for the treatment of lower caliceal stones up to 1 cm. The patient will definitely favour this procedure.
format Text
id pubmed-2684396
institution National Center for Biotechnology Information
language English
publishDate 2008
publisher Medknow Publications
record_format MEDLINE/PubMed
spelling pubmed-26843962009-05-22 Extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter Chaussy, Christian Bergsdorf, Thorsten Indian J Urol Symposium Extracorporeal shockwave lithotripsy (ESWL) has revolutionized the treatment of urinary calculi and became the accepted standard therapy for the majority of stone patients. Only for stones located in the lower calix, ESWL displayed a limited efficacy. Since the stone-free rate seemed to be preferential, endoscopic maneuvers like percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) have been proposed as the primary approach for this stone localization. Stone size seems to be the most important parameter in regard to the stone-free rate, whereas anatomical characteristics of the lower pole collecting system are discussed controversial. Various studies show a good stone clearance between 70-84% for stones up to 1 cm in diameter. Additional physical and medical measures are suitable to improve treatment results. Stone remnants after ESWL, defined as clinical insignificant residual fragments (CIRF) will not cause problems in every case and will pass until up to 24 months after treatment; in total 80-90% of all patients will become stone-free or at least symptom-free. When complete stone-free status is the primary goal, follow-up examinations with new radiological technologies like spiral CT show that the stone-free rate of ESWL and endoscopically treated patients (RIRS) does not differ significantly. However, in comparison to endoscopic stone removal, shockwave therapy is noninvasive, anesthesia-free and can be performed in an outpatient setup. Therefore, ESWL remains the first choice option for the treatment of lower caliceal stones up to 1 cm. The patient will definitely favour this procedure. Medknow Publications 2008 /pmc/articles/PMC2684396/ /pubmed/19468510 http://dx.doi.org/10.4103/0970-1591.44260 Text en © Indian Journal of Urology http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Symposium
Chaussy, Christian
Bergsdorf, Thorsten
Extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter
title Extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter
title_full Extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter
title_fullStr Extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter
title_full_unstemmed Extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter
title_short Extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter
title_sort extracorporeal shockwave lithotripsy for lower pole calculi smaller than one centimeter
topic Symposium
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684396/
https://www.ncbi.nlm.nih.gov/pubmed/19468510
http://dx.doi.org/10.4103/0970-1591.44260
work_keys_str_mv AT chaussychristian extracorporealshockwavelithotripsyforlowerpolecalculismallerthanonecentimeter
AT bergsdorfthorsten extracorporealshockwavelithotripsyforlowerpolecalculismallerthanonecentimeter