title: Is stone clearance after shockwave lithotripsy in patients with solitary upper-caliceal stone influenced by anatomic differences in the pelvicaliceal system?
abstract: OBJECTIVE
  We investigated the effect of pelvicaliceal differences on stone clearance after extracorporeal shockwave lithotripsy (SWL) in patients with solitary upper-caliceal stones.
  
  
  METHODS
  The clinical records of patients with solitary upper-caliceal stones who underwent SWL between 1996 and 2004 were reviewed. After excluding patients with hydronephrosis, significant anatomic abnormalities, non-calcium stones, metabolic abnormalities, recurrent stone disease, multiple stones, and previous renal surgery, 42 patients with a mean stone size of 153.47 mm2 (range 20-896 mm2) were enrolled in this study. They were divided into three groups according to stone burden (group 1 < or =100 mm2, group 2,101 mm2-200 mm2, and group 3 >200 mm2). Upper-pole infundibulopelvic angle (IPA), infundibular length (IL), and infundibular width (IW) were measured from intravenous urograms.
  
  
  RESULTS
  Of the total, 29 patients (69%) were stone free after SWL treatment. The differences in the upperpole IPA, IL, and IW of stone-free patients and patients with residual stones were not statistically significant (P = 0.85, P = 0.89, and P = 0.37, respectively). Again, there were no statistically significant differences in terms of upper IPA, IW, and IL in comparing the three groups divided by initial stone size.
  
  
  CONCLUSIONS
  Upper-caliceal anatomy does not exert a significant impact on stone clearance after SWL for isolated upper-caliceal stones. To best of our knowledge, this is the first study to investigate the effects of pelvicaliceal anatomy on SWL treatment for upper-caliceal stones, so there is a need for further investigations to confirm our findings.
authors.affiliation: Department of Urology, Gazi University School of Medicine, Ankara, Turkey. borakupeli@yahoo.com
authors.forename: Bora
authors.initials: B
authors.lastname: Küpeli
authors.forename: Cenk
authors.initials: C
authors.lastname: Acar
authors.forename: Serhat
authors.initials: S
authors.lastname: Gürocak
authors.forename: Cağri
authors.initials: C
authors.lastname: Güneri
authors.forename: Ustünol
authors.initials: U
authors.lastname: Karaoglan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Bozkirli
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D007670:Kidney Calices / Q000033:anatomy & histology* / Q000473:pathology*; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged