Editor's Comment

Abstract

, provided on page 195 a thorough presentation and discussion on how to choose extracorporeal shock wave lithotripsy (SWL) and percutaneous nephrolithotomy (PNL) for treating renal pelvic stones. The authors stated that the most important to consider is that there is a rational approach to the selection of SWL or PNL. Each modality has advantages and disadvantages, and the application of either one should be based on well-defined factors. These variables include stone factors such as number, size, and composition; factors related to the stone's environment, including the stone's location, spatial anatomy of the renal collecting system, presence of hydronephrosis, and other anatomic variables, such as the presence of calyceal diverticula and renal anomalies; and clinical or patient factors like morbid obesity, the presence of a solitary kidney, and renal insufficiency. The morbidity of each procedure in relation to its efficacy should be taken into account. This article synthesized the current knowledge, and provided guidelines that represent state-of-the-art recommendations for treatment of stones of the renal pelvis using these 2 modalities.