http://matera.fimmg.org/Linee%20guida/Linee%20guida%20nella%20nefrolitiasi%20(ing).pdf

Guidelines on urolithiasis

Lower pole i: a prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis—initial results

Management of Lower Pole Nephrolithiasis: A Critical Analysis

Lower caliceal stone clearance after shock wave lithotripsy or ureteroscopy: the impact of lower pole radiographic anatomy

Current State and Future Developments of Noninvasive Treatment of Human Urinary Stones With Extracorporeal Shock Wave Lithotripsy

Extracorporeal shock wave lithotripsy was used for the treatment of 1060 patients or 1128 kidneys with solitary stones. There were 528 pelvic stones, 82 upper caliceal stones, 120 middle caliceal stones and 398 lower caliceal stones. These groups were divided into two subgroups of large (>15 mm) and small (≤15 mm) stones. A total of 1232 treatments were carried out (1.16/patient or 1.09/kidney) and 91% of the patients underwent a single treatment. Auxiliary procedures were required in 5% of the patients and the complication rate was 3%. Overall, 74% of the patients were stone-free after 3 months of follow-up. Of the 26% with residual stones, 18% had sand (≤2 mm fragments) or match-heads (≤4 mm), 6% had fragments (≤5 mm) and 2% had no fragmentation at all. A stone-free result occurred in approximately 87% with small pelvic and upper caliceal stones, whereas large stones in these locations became stone-free in approximately 70% of cases. Both large and small stones in the lower half of the kidney (mid and lower calices) become stone-free less frequently (to a statistically significant degree) than do similar stones located in the pelvis or upper calices.

ESWL: stone-free efficacy based upon stone size and location

Bladder reconstruction may be required in a variety of pathological conditions, including bladder cancer, irradiation cystitis, interstitial cystitis, tuberculosis, and various congenital anomalies. Currently, bladder reconstruction is done with an autogenous bowel segment. Use of a total prosthetic bladder as an intracorporeal urinary reservoir has been an elusive goal for many decades. Many investigational and a few clinical trials have been performed in an attempt to develop a near-nornal bladder prosthesis utilizing alloplastic materials. To date the ideal prosthetic bladder has not been developed. However, cumulative experimental studies suggest that many, perhaps all, of the ideal functional characteristics of a total prosthetic bladder are possible. Basically, two different alloplastic models have been investigated.

The prosthetic bladder

A staging system for recording the distribution of calculi within the upper urinary tract is presented. The system incorporates descriptors of calculus size, location, complexity and relevant associated anatomical factors. The use of the staging system in stratifying the calculus disease in 1,491 patients treated at an ESWL center into subgroups is demonstrated. Accurate classification of stone disease extent will facilitate comparison of treatment results.

D. P. Griffith

Papers

ESWL: stone-free efficacy based upon stone size and location

The prosthetic bladder

Staging upper tract urinary calculi: analysis of an ESWL center's population