Should percutaneous nephrolithotripsy be considered the primary therapy for lower pole stones?
OBJECTIVE
The efficacy of percutaneous nephrolithotripsy (PCNL) as a primary therapy for the treatment of lower pole caliceal lithiasis was determined.


METHODS
We reviewed 144 consecutive files of patients, over a period of 10 years, with noncomplicated lower pole calculi, who underwent PCNL after a single unsuccessful session of extracorporeal shockwave lithotripsy (SWL).


RESULTS
The stone-free rate for stones less than 10 mm was 95%. A 97% rate was accomplished for stones between 11 and 20 mm and a 98% rate for stones larger than 20 mm. PCNL achieved a mean overall stone-free rate of 96.7% after a 3-month follow-up, regardless of stone size. PCNL outclasses SWL, when stratified by stone burden and lower pole location. No significant postoperative complications were encountered.


CONCLUSIONS
PCNL is a safe and effective procedure for the management of lower pole caliceal calculi after a single unsuccessful SWL session. This procedure should be considered the primary method for the treatment of lower pole stones.
Pardalidis
Nick P
NP
Department of Urology, Athens Medical Centre, Athens, Greece. npardali@otenet.gr
Andriopoulos
Nick A
NA
Sountoulidis
Petros
P
Kosmaoglou
Eleni V
EV
D005260:Female; D006801:Humans; D007670:Kidney Calices / Q000601:surgery*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged