Lower-Pole Caliceal Stone Clearance After Shockwave Lithotripsy, Percutaneous Nephrolithotomy, and Flexible Ureteroscopy: Impact of Radiographic Spatial Anatomy
Elbahnasy A, Clayman R, Shalhav A, Hoenig D, Chandhoke P, Lingeman J, Denstedt J, Kahn R, Assimos D, and Nakada S

Spatial anatomy of the lower renal pole, as defined by the infundibulopelvic angle (LIP angle), infundibular length (IL), and infundibular width (IW), plays a significant role in the stone-free rate after shockwave lithotripsy. A wide LIP angle, a short IL, and a broad IW, individually or in combination, favor stone clearance, whereas a LIP <70�, an IL >3cm, or an IW <5 mm are individually unfavorable. When all three unfavorable factors or an unfavorable LIP and IL coexist, the post-SWL stone-free rate falls to 50% or less. Using these criteria, more than one-fourth of our patients with a lower-pole calculus might have been better served by an initial percutaneous or perhaps ureteroscopic procedure, neither of which is significantly affected by the lower-pole spatial anatomy.

Journal of Endourology, Vol. 12, Number 2, Apr 1998

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