Limitations of extracorporeal shockwave lithotripsy for lower caliceal stones: anatomic insight

J Endourol. 1994 Aug;8(4):241-7. doi: 10.1089/end.1994.8.241.

Abstract

In addition to gravity-dependent position, we suppose that other particular anatomic features may be important in the retention of stone debris in lower calices after extracorporeal shockwave lithotripsy (SWL). We analyzed the inferior-pole collecting system anatomy in 146 three-dimensional polyester resin corrosion endocasts of the pelviocaliceal system. In 74% of the cases, there was an angle of greater than 90 degrees formed between the lower infundibulum and the renal pelvis, and in 26%, the angle was 90 degrees or less. In 60%, there was a lower infundibulum 4 mm or larger in diameter. The inferior pole was drained by multiple calices disposed in two rows in 57% of the cases and by one midline caliceal infundibulum in 43%. We believe that the physician must appreciate these anatomic features when considering SWL to treat calculi located in lower calices.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cadaver
  • Corrosion Casting
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Kidney / anatomy & histology*
  • Kidney Calculi / therapy*
  • Kidney Calices* / anatomy & histology
  • Kidney Pelvis / anatomy & histology
  • Lithotripsy*
  • Male
  • Posture