Impact of Residual Fragments following Endourological Treatments in Renal Stones
Today, shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), and flexible ureterorenoscopy (URS) are the most widely used modalities for the management of renal stones. In earlier series, treatment success of renal calculi assessed with KUB radiography, ultrasound, or intravenous pyelog...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Advances in Urology |
| Online Access: | http://dx.doi.org/10.1155/2012/813523 |
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| author | Cenk Acar Cag Cal |
| author_facet | Cenk Acar Cag Cal |
| author_sort | Cenk Acar |
| collection | DOAJ |
| description | Today, shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), and flexible ureterorenoscopy (URS) are the most widely used modalities for the management of renal stones. In earlier series, treatment success of renal calculi assessed with KUB radiography, ultrasound, or intravenous pyelography which are less sensitive than CT that leads to be diversity of study results in reporting outcome. Residual fragments (RFs) after interventional therapies may cause pain, infection, or obstruction. The size and location of RFs following SWL and PCNL are the major predictors for clinical significant symptoms and stone events requiring intervention. There is no consensus regarding schedule for followup of SWL, PCNL, and flexible URS. Active monitoring can be recommended when the stones become symptomatic, increase in size, or need intervention. RFs <4 mm after SWL and <2 mm after PCNL and flexible URS could be actively monitored on an annual basis with CT. Early repeat SWL and second-look endoscopy are recommended after primary SWL and PCNL, respectively. There is insufficient data for flexible URS, but RFs can be easily treated with repeat URS. Finally, medical therapy should be tailored based on the stone analysis and metabolic workup that may be helpful to prevent regrowth of the RFs. |
| format | Article |
| id | doaj-art-2abc268ca4c8451a84e3f305efd604bb |
| institution | Kabale University |
| issn | 1687-6369 1687-6377 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
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| series | Advances in Urology |
| spelling | doaj-art-2abc268ca4c8451a84e3f305efd604bb2025-02-03T06:05:19ZengWileyAdvances in Urology1687-63691687-63772012-01-01201210.1155/2012/813523813523Impact of Residual Fragments following Endourological Treatments in Renal StonesCenk Acar0Cag Cal1Department of Urology, Faculty of Medicine, Pamukkale University, 20070 Denizli, TurkeyDepartment of Urology, Faculty of Medicine, Ege University, 35100 Izmir, TurkeyToday, shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), and flexible ureterorenoscopy (URS) are the most widely used modalities for the management of renal stones. In earlier series, treatment success of renal calculi assessed with KUB radiography, ultrasound, or intravenous pyelography which are less sensitive than CT that leads to be diversity of study results in reporting outcome. Residual fragments (RFs) after interventional therapies may cause pain, infection, or obstruction. The size and location of RFs following SWL and PCNL are the major predictors for clinical significant symptoms and stone events requiring intervention. There is no consensus regarding schedule for followup of SWL, PCNL, and flexible URS. Active monitoring can be recommended when the stones become symptomatic, increase in size, or need intervention. RFs <4 mm after SWL and <2 mm after PCNL and flexible URS could be actively monitored on an annual basis with CT. Early repeat SWL and second-look endoscopy are recommended after primary SWL and PCNL, respectively. There is insufficient data for flexible URS, but RFs can be easily treated with repeat URS. Finally, medical therapy should be tailored based on the stone analysis and metabolic workup that may be helpful to prevent regrowth of the RFs.http://dx.doi.org/10.1155/2012/813523 |
| spellingShingle | Cenk Acar Cag Cal Impact of Residual Fragments following Endourological Treatments in Renal Stones Advances in Urology |
| title | Impact of Residual Fragments following Endourological Treatments in Renal Stones |
| title_full | Impact of Residual Fragments following Endourological Treatments in Renal Stones |
| title_fullStr | Impact of Residual Fragments following Endourological Treatments in Renal Stones |
| title_full_unstemmed | Impact of Residual Fragments following Endourological Treatments in Renal Stones |
| title_short | Impact of Residual Fragments following Endourological Treatments in Renal Stones |
| title_sort | impact of residual fragments following endourological treatments in renal stones |
| url | http://dx.doi.org/10.1155/2012/813523 |
| work_keys_str_mv | AT cenkacar impactofresidualfragmentsfollowingendourologicaltreatmentsinrenalstones AT cagcal impactofresidualfragmentsfollowingendourologicaltreatmentsinrenalstones |