Is Lower Pole Caliceal Anatomy Predictive of Extracorporeal Shock Wave Lithotripsy Success for Primary Lower Pole Kidney Stones

ABSTRACTPurpose: The management of lower pole kidney stones is controversial. We examined whether lower pole caliceal anatomy could predict the success of extracorporeal shock wave lithotripsy of primary lower pole kidney stones 20 mm. or less.Materials and Methods: From December 1997 to June 2001, 246 adults with a single, 20 mm. or less radiopaque lower pole renal stone were treated with the Doli 50 lithotriptor (Dornier Medical Systems, Marietta, Georgia) while under general anesthesia. Of the 246 patients 190 (77%) had excretory urography available for review. Lower pole infundibular length and width, lower pole infundibulopelvic angle and caliceal-pelvic height were measurable on 161 (85%), 129 (68%), 128 (67%) and 163 (86%) excretory urograms, respectively. Extracorporeal shock wave lithotripsy was considered a failure if residual stone fragments remained after 1 month, or an auxiliary procedure or re-treatment was required.Results: The overall stone-free rate was 78% (32 of 41) for stones 5 mm. or ...