The natural history of asymptomatic calyceal stones

Darrad, Maitrey; Yallappa, Sachin; Metcalfe, J. E.; Subramonian, Kesavapillai

doi:10.1111/bju.14354

Cited by 27 publications

(44 citation statements)

References 15 publications

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“…[20][21][22] Several studies have reported factors associated with surgical intervention during active surveillance, including male sex, age (£50 years), the rate of stone growth, stone history, and stone size. 3,5,7,15,17 In this study, age £50 years and a history of surgical intervention were significant factors associated with surgical intervention, but not stone size <5 mm. Interestingly, in the present study, the incidence of surgical intervention was low in patients above 50 years of age with asymptomatic renal stones £5 mm and without a history of surgical intervention.…”

Section: Discussionmentioning

confidence: 50%

“…There is substantial variation in reported rates of surgical intervention from 7.1% to 40%, spontaneous stone passage from 3.1% to 29.1%, symptom development from 7.3% to 77.0%, and stone growth from 5.2% to 66.0% in patients with asymptomatic renal stones (Supplementary Table S4). 3,[13][14][15][16][17][18] This discrepancy is believed to be due to the difference in indications for surgical intervention, the difference in the definition for symptom development or stone growth, the length of follow-up, and the difference of the cohort in each study. The incidence of surgical intervention in our study is within the range of that from previous reports but is rather high.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The prevalence of urolithiasis has been estimated to be at 3%-7.1% in females and 8%-19% in males. 3,4 Hence, the economical and clinical burden of urolithiasis on the health care system are of great concern.…”

Section: Introductionmentioning

confidence: 99%

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The Natural History of Asymptomatic Renal Stones ≤5 mm: Comparison with ≥5 mm

Kanno

Takahashi

Ito

et al. 2020

Journal of Endourology

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Objectives: To clarify the natural history of asymptomatic renal stones £5 mm in comparison with stones ‡5 mm. Calculi £5 mm are considered insignificant stones, but to what extent stone-related events can occur is unclear.Patients and Methods: In this retrospective study, 207 patients with asymptomatic renal stones confirmed by both CT and ultrasonography performed on the same day were enrolled. A follow-up ultrasound was performed every 6 months. The active indications for surgical intervention included stone relocations into the ureter and stone-related symptoms. The primary endpoint was the rate of surgical intervention.Results: A total of 207 patients (71 cases with stones £5 mm and 136 cases with stones >5 mm) were included in this study. At a median follow-up of 3.3 years, 14 patients (20%) from the £5-mm group and 52 (38%) from the >5-mm group underwent surgical treatment ( p = 0.0067). Moreover, 11 patients (16%) from the £5-mm group and 27 (20%) from the >5-mm group received surgical intervention as they manifested active indications, showing no significant difference ( p = 0.44). As regards stone events, there were no significant differences in spontaneous stone passage, pain, hematuria, and stone growth. Multivariate analysis revealed that age £50 years and a history of stone surgery were significant factors, but stone size was not. Conclusion: About 20% of asymptomatic renal stones £5 mm require surgical treatment within 5 years.

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

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The Natural History of Asymptomatic Renal Stones ≤5 mm: Comparison with ≥5 mm

Kanno

Takahashi

Ito

et al. 2020

Journal of Endourology

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“…In many series, the surgical intervention required in asymptomatic calyceal stones that ranged 19-25% [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Some of the advantages of ESWL include shorter operative time and hospital stay in comparison to RIRS [20]. The need for long-term follow-up for asymptomatic calyceal stones and the finding that painless silent hydronephrosis developed in 2% of patients raise concern and mandate active treatment rather than the wait-and-see approach [17].…”

Section: Discussionmentioning

confidence: 99%

Fragmentation and propulsive effect of shock wave lithotripsy in treatment of small renal calculi

Abid

Hussein

2020

Afr J Urol

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Background Small renal calculi are frequently observed in clinical practice, and chemo-lytic therapy has limited effects. The purpose of the study is to evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) in the treatment of small renal calculi. Methods We studied 60 patients with small renal stones from March 2017 to March 2019. After excluding eight patients with incomplete data, the remaining 52 patients were evaluated. Patients with symptomatic single or multiple stones of 6–8 mm in diameter or asymptomatic on ultrasound and kidney-ureter-bladder radiograph were eligible for inclusion. Small stones were treated by ESWL. The data were analyzed using the Statistical Packages for Social Sciences - version 25 (IBM Corporation). Results The mean age of the 52 patients was 34.5 ± 9.5 years. Forty-one (78.8%) patients were symptomatic, while 11 (21.2%) were asymptomatic. Forty-seven (90.4%) had single small renal stones, while four patients had two stones (7.7%) and only one patient had three stones (1.9%). Forty-five stones were successfully treated by ESWL, while 13 stones failed to respond. Conclusion ESWL is a useful tool for treating small renal calculi; it works either by fragmenting the stones or by acting as a pushing force. However, further large prospective studies are needed to corroborate the above conclusions.

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Konservative Steintherapie

Miernik¹

2021

Komplikationen in Der Urologie

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The natural history of asymptomatic calyceal stones

Cited by 27 publications

References 15 publications

The Natural History of Asymptomatic Renal Stones ≤5 mm: Comparison with ≥5 mm

The Natural History of Asymptomatic Renal Stones ≤5 mm: Comparison with ≥5 mm

Fragmentation and propulsive effect of shock wave lithotripsy in treatment of small renal calculi

Konservative Steintherapie

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