IMPACT OF LOWER CALYCEAL ANATOMY AND STONE SIZE ON STONE CLEARANCE AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) IN ADULTS
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Date
2012-05
Authors
CHIANG, YOONG FEI
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan Universiti Sains Malaysia
Abstract
Objective: This study was conducted to evaluate the impact of radiological
anatomy of the lower calyx and stone size on lower pole stone clearance after
extracorporeal shock wave lithotripsy (ESWL) in adults.
Methods: We retrospectively evaluated 20 patients with age older than 18, who
had ESWL at USM Hospital within 25 months(September 2009 till September
2011) for radio-opaque lower pole calculi with the largest diameter up to 20mm.
Stone size and lower pole anatomy, as defined by the infundibulopelvic angle,
infundibular length and width were assessed in pre-ESWL intravenousurogram
(IVU). All patients were treated with ESWL and outcome of the stone clearance
were reviewed in KUB radiograph performed 1-4 months after the last ESWL.
Results: Only 10 patients (50%) of the study were stone-free after ESWL. Mean
stone size and infundibular length were 14.36mm ± 3.98mm and 27.79mm ±
6.52mmrespectively. Median infundibulopevic angle and infundibular width
were33.0° (IqR = 19.75°) and 4.90mm (IqR = 6.45mm) respectively. No
statistically significant difference found in all IVU parameter means or medians
between stone-free group and residual stone group. There was also no
association of any IVU parameters with stone-free status.
Conclusion: Stone size and lower calyceal anatomy have no significant impact
on stone clearance after ESWL. However, further examination of the IVU
parameters and further explore for other contributing factors are still warranted.
Description
Keywords
Radiology