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

Surgery

Medical & Surgical Urology

Author(s): Sampaio FJ, Aragao AH

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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. This article was published in J Endourol and referenced in Medical & Surgical Urology

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