Solitary stones of the lower renal calyx: how to treat?

Martov, A G; Ergakov, D V; Andronov, A. S.; Dutov, S.V. Dutov; Тахаев, Р. А.; Kil'chukov, Z I; Moskalenko, Svitlana

doi:10.18565/urol.2017.2.28-35

Cited by 3 publications

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“…Obese patients with kidney stones are significantly more challenging to treat than normal-weight patients ( 18 , 19 ). Due to the difficulty of localization and the distance between the skin and the kidney stone, ESWL is not as effective as RIRS or PCNL in treating obese patients ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of external physical vibration lithecbole in obese patients with lower pole stones <15 mm after ESWL: a single-centre, randomized, open label clinical trial

Li,

2023

Front. Med.

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ObjectiveTo investigate the efficacy and safety of external physical vibration lithecbole (EPVL) in obese patients with <15 mm lower pole stones following extracorporeal shock wave lithotripsy (ESWL).MethodsTwo hundred and ninety-nine obese patients with BMI greater than 30 kg/m2 and lower pole stones smaller than 15 mm were prospectively randomized into two groups. While ESWL was the only option in the control group, patients in the treatment group accepted EPVL after receiving ESWL. Imaging tests were used to compare the stone expulsion status on day 1 and the stone-free rates (SFR) on the first, second, and fourth weekends.ResultsAll 299 obese patients were randomly divided into two groups, with 152 patients assigned to the treatment group and 147 assigned to the control group. EPVL was effective in facilitating the expulsion of stone fragments. The treatment group’s stone expulsion rate on the first day following EPVL was significantly greater than the control group’s (66.4% vs. 51.7%, p = 0.009). Stone clearance rates in the treatment and control groups were 63.2 and 55.1% at 1 week (p = 0.041), 84.9 and 70.7% at 2 weeks (p = 0.011), and 90.8 and 79.6% at 4 weeks (p = 0.017), respectively. The complications (hematuria, lumbago, and fever) between the groups did not show any significance (p > 0.05). Patients in the treatment group received an average of 5.2 sessions.ConclusionEPVL is an efficient and secure procedure that facilitates lower pole stone discharge in obese patients following ESWL treatment. To support the aforementioned conclusions, additional large-scale multi-center prospective studies are required.

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Section: Discussionmentioning

confidence: 99%

Effect of external physical vibration lithecbole in obese patients with lower pole stones <15 mm after ESWL: a single-centre, randomized, open label clinical trial

Li,

2023

Front. Med.

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“…Martov et al . [ 18 ] concluded that ESWL, flexible ureteroscopy, and Percutaneous Nephro-Lithotomy (PNL) have equal outcomes for the treatment of single lower calyceal stone without referral to obese patients. Moreover, Mezentsev[ 19 ] reported that in obese patients, ESWL shock wave using the ordinary method had a success rate of just 60%.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of extracorporeal shockwave lithotripsy, with modified position of the machine head in the treatment of lower calyceal stones in obese patients

et al. 2022

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Context: Extracorporeal shock wave lithotripsy (ESWL) has inferior results in the lower calyceal stones, especially in obese patients. Aims: This study aimed at evaluating of the efficacy of extracorporeal shockwave lithotripsy, with modified position of the machine head in the treatment of single lower calyceal stones in obese patients. Settings and Design: This was a prospective study (phase IV trial). Subjects and Methods: We studied the anterior rotation of the shock wave machine head in obese patients for the treatment of lower calyx stones. From February 2015 to June 2019, 105 obese patients (body mass index [BMI] ≥35) having lower calyx stones (≤20 mm) underwent ESWL at our institute. The procedure was done in a supine position, and the head of the shock-wave machine was tilted anteriorly. ESWL was considered successful if the kidney was completely cleared of stones. Statistical Analysis Used: The statistical methods used were descriptive statistics, mean, standard deviation frequency analysis, Chi-square test, unpaired t -test test, and Pearson correlations (r). Results: The mean BMI of these patients was 39.71 ± 2.8 kg/m 2 , the mean stone size was 17.4 ± 2.1 mm, the mean stone density was 767.1 ± 193.4 Hounsfield unit, and the mean of skin to stone distance (SSD) was 145.4 ± 4.5 mm. ESWL was successful in 86 (81.9%) patients; 13 patients (12.4%) showed complete success after the first session, while 37 (35.2%), 25 (23.8%), and 11 (10.5%) patients showed success after the second, third, and fourth sessions, respectively. ESWL failed in 19 (19.1%) cases. The success rate decreased significantly with higher stone density and SSD ( P < 0.001), with negative correlations ( r values) of −0.871 and −0.811, respectively. Conclusions: Anterior rotation of the head of the shock wave machine is a suitable option for the treatment of lower calyceal stones in obese patients.

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Retrospective study of single-use digital flexible ureteroscopic lithotripsy versus miniaturized percutaneous nephrolithotomy for 1.5–2.5cm lower pole renal stones

Meng,

Zhang,

Wang

et al. 2023

Int Urol Nephrol

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Solitary stones of the lower renal calyx: how to treat?

Cited by 3 publications

References 0 publications

Effect of external physical vibration lithecbole in obese patients with lower pole stones <15 mm after ESWL: a single-centre, randomized, open label clinical trial

Effect of external physical vibration lithecbole in obese patients with lower pole stones <15 mm after ESWL: a single-centre, randomized, open label clinical trial

Efficacy of extracorporeal shockwave lithotripsy, with modified position of the machine head in the treatment of lower calyceal stones in obese patients

Retrospective study of single-use digital flexible ureteroscopic lithotripsy versus miniaturized percutaneous nephrolithotomy for 1.5–2.5cm lower pole renal stones

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