Renal anatomic features

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Is The Gravity Effect of Radiographic Anatomic Features Enough To Justify Stone Clearance or Fragments Retention Following Extracorporeal Shock Wave Lithotripsy (SWL)

Journal Title, Volume, Page: 
Urological Research August 2012, Volume 40, Issue 4, pp 339-344
Year of Publication: 
2011
Authors: 
Mahmoud Mustafa
Urology Department, Osmaniye State Hospital, Osmaniye, Turkey
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Preferred Abstract (Original): 

We determined whether the gravity effect of radiographic anatomic features on the preoperative urography (IVP) are enough to predict fragments clearance after shock wave lithotripsy (SWL). A Total of 282 patients with mean age 45.8 ± 13.2 years (189 male, 93 female), who underwent SWL due to renal calculi between October 2005 and August 2009 were enrolled. The mean calculi load was 155.72 ± 127.66 mm². The patients were stratified into three groups: patients with pelvis calculi (group 1); patients with upper or middle pole calculi (group 2) and patients with lower pole calculi (group 3). Three angles on the pretreatment IVP were measured: the inner angle between the axis of the lower pole infundibular and ureteropelvic axis (angle I); the inner angle between the lower pole infundibular axis and main axis of pelvis-ureteropelvic (UP) junction point (angle II) and the inner angle between the lower pole infundibular axis and perpendicular line (angle III). Multivariate analysis was used to define the significant predictors of stone clearance. The overall success rate was 85.81%. All angles, sessions number, shock waves number and stone burden were significant predictors of success in patients in group 1. However, in group 2 only angle II and in group 3 angles I and II had significant effect on stone clearance. Radiographic anatomic features have significant role in determining the stone-free rate following satisfactory fragmentation of renal stones with SWL. The measurement of infundibulopelvic angle in different manner helps to predict the stone-free status in patients with renal calculi located not only in lower pole, but also in renal pelvis and upper or middle pole. Gravity effect is not enough to justify the significant influence of the radiographic anatomic features on the stone clearance and fragments retention after SWL.

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Impact of Gravity-Related Radiographic Anatomic Features on Clearance of Renal Pelvis Stones After Extracorporeal Shock Wave Lithotripsy

Journal Title, Volume, Page: 
Turkish Journal of Urology 2010;36(3):286-291
Year of Publication: 
2010
Authors: 
Mahmoud Othman Mustafa
İzmir Atatürk Research and Education Hospital, Department of Urology, İzmir, Turkey
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Sacit Nurigörgel
İzmir Atatürk Research and Education Hospital, Department of Urology, İzmir, Turkey
Ertuğrul Şefik
İzmir Atatürk Research and Education Hospital, Department of Urology, İzmir, Turkey
Cengiz Girgin
İzmir Atatürk Research and Education Hospital, Department of Urology, İzmir, Turkey
Çetin Dinçel
İzmir Atatürk Research and Education Hospital, Department of Urology, İzmir, Turkey
Preferred Abstract (Original): 

Objective: To assess the effect of the gravity-related radiographic features on the success rate of extracorporeal shock wave lithotripsy (SWL) in renal stones.
Materials and methods: A total of 79 patients (mean age 47.34±12.9 year) who underwent SWL due to renal pelvis stones (mean area 162.58±130.31 mm²) between 2005 and 2008 were enrolled. Three angles on the pretreatment excretory urography were measured; the inner angle between the axis of the lower pole infundibular and ureteropelvic axis (angle 1), lower pole infundibular axis and main axis of pelvis-ureteropelvic junction point (angle 2), and lower pole infundibular axis and perpendicular line (angle 3). Age, number of session, stone burden, numbers of shock waves, and presence of hydronephrosis were defined for all patients. The significant predictors of stone-free rate after the application of SWL was defined.
Results: The success rate was 53.2%. All angles, number of sessions, stones burden, and number of shock waves were significant predictors of stone free rate. However, age, sex and the presence of hydronephrosis did not show similar effects.
Conclusions: Gravity-related factors have significant role on the stone-free rate in patients treated with SWL for renal pelvis stones. These radiographic parameters may be used to determine the patients who will benefit from SWL.

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