Evaluation of the effects of relationships between main spatial lower pole calyceal anatomic factors on the success of shock-wave lithotripsy in patients with lower pole kidney stones.
OBJECTIVE
To evaluate the effects of lower pole calyceal anatomy on lower pole stone clearance after shock-wave lithotripsy (SWL).


METHODS
A total of 133 patients who had single lower pole radio-opaque stones treated with SWL alone and who became stone-free or had clinically insignificant residual fragments (CIRF) were included in the study. Pre-shock-wave lithotripsy intravenous urograms were used to determine the lower pole infundibular width and length, lower pole infundibulopelvic (LPIP) angle, caliceal pelvic height (CPH), and lower infundibular length-to-width ratio. In addition, to evaluate the relationship between LPIP and CPH, a more simple alternative measurement instead of LPIP angle, called the parenchyma-to-ureter distance (PUD), was suggested. The correlation between LPIP and PUD was then examined, and a good correlation was found between these values (P <0.000, r = 0.64). The PUD/CPH ratio was also calculated.


RESULTS
The stone-free rate was 62%. According to the cutoff points, the lower infundibular length-to-width ratio and PUD/CPH ratio were different in the stone-free and CIRF groups by univariate analysis but not by multivariate analysis.


CONCLUSIONS
None of the anatomic factors had a statistically significant effect in predicting the success of SWL in patients with lower pole stones. Nevertheless, evaluation of relationships between lower pole anatomic factors may offer some help in reaching a more accurate interpretation of lower pole stone clearance after SWL.
Sahinkanat
Tayfun
T
Department of Urology, University of Kahramanmaras Sutcuimam School of Medicine, Kahramanmaras, Turkey. tskanat@yahoo.com
Ekerbicer
Hasan
H
Onal
Bulent
B
Tansu
Nejat
N
Resim
Sefa
S
Citgez
Sinharib
S
Oner
Armagan
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D007670:Kidney Calices / Q000033:anatomy & histology*; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D012074:Remission Induction