Urol Ann. 2017 Apr-Jun;9(2):145-149. doi: 10.4103/UA.UA_95_16.
Management of renal caliceal diverticular stones: A decade of experience.
Urology annals
Madhusudan Patodia, Rahul Janak Sinha, Siddharth Singh, Vishwajeet Singh
Affiliations
Affiliations
- Department of Urology, Narayana Multispeciality Hospital, Jaipur, Rajasthan, India.
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
PMID: 28479765
PMCID: PMC5405657 DOI: 10.4103/UA.UA_95_16
Abstract
OBJECTIVE: The objective of this study is to evaluate our methods for management of renal caliceal diverticular stones (CDS).
MATERIALS AND METHODS: We conducted a retrospective study from January 2005 to July 2015 and included patients who were treated for renal CDS. Patients were evaluated for treatment modality, puncture site (in case percutaneous nephrolithotomy [PCNL] attempted), operative time, stone clearance rate, and complications. During PCNL, if the infundibulum was found to connect the diverticulum to the calyx, then a double J stent was placed. No attempt was made to dilate the diverticular neck or to create a neoinfundibulum.
RESULTS: Twenty-four patients were treated for CDS during the study period. Two patients underwent shockwave lithotripsy, and 22 were managed by PCNL. Mean stone size was 16.37 mm (range: 6-35 mm) and mean diverticulum size was 20.62 mm (range: 12-37 mm). No fulguration was done in initial 17 patients, while fulguration by Holmium Laser was performed in the last five cases treated with PCNL. Mean operative time was 70.31 min (range: 47-90 min). Mean follow-up was 34 months, diverticulum resolved in 14 patients and reduced in size in 7 patients.
CONCLUSION: Caliceal diverticular calculi can be treated most efficiently by PCNL. Stone-guided puncture and no attempt to dilate or create neoinfundibulum reduces operative time and morbidity while yielding high stone-free rate.
Keywords: Caliceal diverticular stone; caliceal diverticulum; percutaneous nephrolithotomy
Conflict of interest statement
There are no conflicts of interest.
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