Skip to main content
Top
Published in: Urolithiasis 4/2014

01-08-2014 | Original Paper

Is retrograde flexible nephrolithotripsy feasible for calyceal diverticular stone?

Authors: Bulent Erkurt, Murat Can Kiremit, Bulent Altay, Vahit Guzelburc, Mustafa Soytas, Firat Erdogan, Cem Cahit Barisik, Selami Albayrak

Published in: Urolithiasis | Issue 4/2014

Login to get access

Abstract

The aim of this study is to manage the calyceal diverticular (CD) stone, several treatment options were applied but it is still a challenging condition of endourology. In this retrospective study, we aim to report the results of our patients with CD stones treated with retrograde flexible nephrolithotripsy (RFNL). A total of 47 patients (55 procedures) who underwent RFNL by a single surgeon for CD stones from January 2004 to March 2013 were evaluated retrospectively. The demographic properties and initial complaints of those patients have been recorded along with their comorbidities and previous history of stone management. Moreover, the size and number of the stones, the duration of the surgery, fluoroscopy time, stone-free rate (SFR) and postoperative complications of the patients have been evaluated. The mean age was 41.8 years (range 16–71). Of the study population, 31 (65.9 %) were male. Mean stone size was 21.1 (7–52) mm whereas in 3 (6.4 %) of the cases the stones could not be reached. Mean duration of the surgery was 92.8 (57–163) min whereas mean fluoroscopy time was 35.9 (14–103) s. After 3 months of follow-up period, the SFR was 85.1 %. No major complications occurred. RFNL with holmium laser and nitinol basket catheter application is a feasible and successful procedure in the management of CD stones. With its high success rates, low incidence of complications and minimal morbidity when compared with other treatment options, RFNL has the potential of becoming the preferred treatment option in the minimally invasive management of patients with CD stones.
Literature
1.
2.
go back to reference Middleton AW Jr, Pfister RC (1974) Stone-containing pyelocaliceal diverticulum: embryogenic, anatomic, radiologic and clinical characteristics. J Urol 111(1):2–6PubMed Middleton AW Jr, Pfister RC (1974) Stone-containing pyelocaliceal diverticulum: embryogenic, anatomic, radiologic and clinical characteristics. J Urol 111(1):2–6PubMed
3.
go back to reference Ellis JH, Patterson SK, Sonda LP, Platt JF, Sheffner SE, Woolsey EJ (1991) Stones and infection in renal caliceal diverticula: treatment with percutaneous procedures. Am J Roentgenol 156(5):995–1000CrossRef Ellis JH, Patterson SK, Sonda LP, Platt JF, Sheffner SE, Woolsey EJ (1991) Stones and infection in renal caliceal diverticula: treatment with percutaneous procedures. Am J Roentgenol 156(5):995–1000CrossRef
4.
go back to reference Timmons JW Jr, Malek RS, Hattery RR, Deweerd JH (1975) Caliceal diverticulum. J Urol 114(1):6–9PubMed Timmons JW Jr, Malek RS, Hattery RR, Deweerd JH (1975) Caliceal diverticulum. J Urol 114(1):6–9PubMed
5.
go back to reference Auge BK, Munver R, Kourambas J, Newman GE, Wu NZ, Preminger GM (2002) Neoinfundibulotomy for the management of symptomatic caliceal diverticula. J Urol 167(4):1616–1620PubMedCrossRef Auge BK, Munver R, Kourambas J, Newman GE, Wu NZ, Preminger GM (2002) Neoinfundibulotomy for the management of symptomatic caliceal diverticula. J Urol 167(4):1616–1620PubMedCrossRef
6.
go back to reference Jones JA, Lingeman JE, Steidle CP (1991) The roles of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy in the management of pyelocaliceal diverticula. J Urol 146(3):724–727PubMed Jones JA, Lingeman JE, Steidle CP (1991) The roles of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy in the management of pyelocaliceal diverticula. J Urol 146(3):724–727PubMed
7.
go back to reference Matlaga BR, Miller NL, Terry C, Kim SC, Kuo RL, Coe FL et al (2007) The pathogenesis of calyceal diverticular calculi. Urol Res 35(1):35–40PubMedCrossRef Matlaga BR, Miller NL, Terry C, Kim SC, Kuo RL, Coe FL et al (2007) The pathogenesis of calyceal diverticular calculi. Urol Res 35(1):35–40PubMedCrossRef
8.
go back to reference Hsu TH, Streem SB (1998) Metabolic abnormalities in patients with caliceal diverticular calculi. J Urol 160(5):1640–1642PubMedCrossRef Hsu TH, Streem SB (1998) Metabolic abnormalities in patients with caliceal diverticular calculi. J Urol 160(5):1640–1642PubMedCrossRef
9.
go back to reference Liatsikos EN, Bernardo NO, Dinlenc CZ, Kapoor R, Smith AD (2000) Caliceal diverticular calculi: is there a role for metabolic evaluation? J Urol 164(1):18–20PubMedCrossRef Liatsikos EN, Bernardo NO, Dinlenc CZ, Kapoor R, Smith AD (2000) Caliceal diverticular calculi: is there a role for metabolic evaluation? J Urol 164(1):18–20PubMedCrossRef
10.
go back to reference Monga M, Smith R, Ferral H, Thomas R (2000) Percutaneous ablation of caliceal diverticulum: long-term followup. J Urol 163(1):28–32PubMedCrossRef Monga M, Smith R, Ferral H, Thomas R (2000) Percutaneous ablation of caliceal diverticulum: long-term followup. J Urol 163(1):28–32PubMedCrossRef
11.
go back to reference Grasso M, Loisides P, Beaghler M, Bagley D (1995) The case for primary endoscopic management of upper urinary tract calculi: I. A critical review of 121 extracorporeal shock wave lithotripsy failures. Urology 45(3):363–371PubMedCrossRef Grasso M, Loisides P, Beaghler M, Bagley D (1995) The case for primary endoscopic management of upper urinary tract calculi: I. A critical review of 121 extracorporeal shock wave lithotripsy failures. Urology 45(3):363–371PubMedCrossRef
12.
go back to reference Mendez-Probst CE, Fuller A, Nott L, Denstedt JD, Razvi H (2011) Percutaneous nephrolithotomy of caliceal diverticular calculi: a single center experience. J Endourol 25(11):1741–1745CrossRef Mendez-Probst CE, Fuller A, Nott L, Denstedt JD, Razvi H (2011) Percutaneous nephrolithotomy of caliceal diverticular calculi: a single center experience. J Endourol 25(11):1741–1745CrossRef
13.
go back to reference Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213PubMedCentralPubMedCrossRef Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213PubMedCentralPubMedCrossRef
14.
go back to reference Canales B, Monga M (2003) Surgical management of the calyceal diverticulum. Curr Opin Urol 13(3):255–260PubMedCrossRef Canales B, Monga M (2003) Surgical management of the calyceal diverticulum. Curr Opin Urol 13(3):255–260PubMedCrossRef
15.
go back to reference Psihramis KE, Dretler SP (1987) Extracorporeal shock wave lithotripsy of caliceal diverticula calculi. J Urol 138(4):707–711PubMed Psihramis KE, Dretler SP (1987) Extracorporeal shock wave lithotripsy of caliceal diverticula calculi. J Urol 138(4):707–711PubMed
16.
go back to reference Turna B, Raza A, Moussa S, Smith G, Tolley DA (2007) Management of calyceal diverticular stones with extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy: long-term outcome. BJU Int. 100(1):151–156PubMedCrossRef Turna B, Raza A, Moussa S, Smith G, Tolley DA (2007) Management of calyceal diverticular stones with extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy: long-term outcome. BJU Int. 100(1):151–156PubMedCrossRef
17.
go back to reference Kim SC, Kuo RL, Tinmouth WW, Watkins S, Lingeman JE (2005) Percutaneous nephrolithotomy for caliceal diverticular calculi: a novel single stage approach. J Urol 173(4):1194–1198PubMedCrossRef Kim SC, Kuo RL, Tinmouth WW, Watkins S, Lingeman JE (2005) Percutaneous nephrolithotomy for caliceal diverticular calculi: a novel single stage approach. J Urol 173(4):1194–1198PubMedCrossRef
18.
go back to reference Gross AJ, Herrmann TR (2007) Management of stones in calyceal diverticulum. Curr Opin Urol 17(2):136–140PubMedCrossRef Gross AJ, Herrmann TR (2007) Management of stones in calyceal diverticulum. Curr Opin Urol 17(2):136–140PubMedCrossRef
19.
go back to reference Basiri A, Radfar MH, Lashay A (2013) Laparoscopic management of caliceal diverticulum: our experience, literature review, and pooling analysis. J Endourol 27(5):583–586PubMedCrossRef Basiri A, Radfar MH, Lashay A (2013) Laparoscopic management of caliceal diverticulum: our experience, literature review, and pooling analysis. J Endourol 27(5):583–586PubMedCrossRef
20.
go back to reference Turk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M et al (2013) Members of the European Association of Urology (EAU) Guidelines Office. Guidelines on urolithiasis. In: EAU guidelines, edition presented at the 28th EAU Annual Congress, Milan Turk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M et al (2013) Members of the European Association of Urology (EAU) Guidelines Office. Guidelines on urolithiasis. In: EAU guidelines, edition presented at the 28th EAU Annual Congress, Milan
21.
go back to reference Fuchs GJ, David R (1989) Flexible ureterorenoscopy, dilatation of narrow caliceal neck, and ESWL: a new, minimally invasive approach to stones in caliceal diverticula. J Endourol 3:255–263CrossRef Fuchs GJ, David R (1989) Flexible ureterorenoscopy, dilatation of narrow caliceal neck, and ESWL: a new, minimally invasive approach to stones in caliceal diverticula. J Endourol 3:255–263CrossRef
22.
go back to reference Sejiny M, Al-Qahtani S, Elhaous A, Molimard B, Traxer O (2010) Efficacy of flexible ureterorenoscopy with holmium laser in the management of stone-bearing caliceal diverticula. J Endourol 24(6):961–967PubMedCrossRef Sejiny M, Al-Qahtani S, Elhaous A, Molimard B, Traxer O (2010) Efficacy of flexible ureterorenoscopy with holmium laser in the management of stone-bearing caliceal diverticula. J Endourol 24(6):961–967PubMedCrossRef
Metadata
Title
Is retrograde flexible nephrolithotripsy feasible for calyceal diverticular stone?
Authors
Bulent Erkurt
Murat Can Kiremit
Bulent Altay
Vahit Guzelburc
Mustafa Soytas
Firat Erdogan
Cem Cahit Barisik
Selami Albayrak
Publication date
01-08-2014
Publisher
Springer Berlin Heidelberg
Published in
Urolithiasis / Issue 4/2014
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-014-0672-1

Other articles of this Issue 4/2014

Urolithiasis 4/2014 Go to the issue