Comparison of Stone-Free Rates as Determined by Radiography and Endoscopy Following Percutaneous Nephrostolithotomy or Combination Therapy

  • John D. Denstedt
  • Ralph V. Clayman
  • Daniel P. Picus

Abstract

The stone-free rate after extracorporeal shock wave lithotripsy (ESWL) is primarily determined by a plain abdominal radiograph (KUB) alone. However, the accuracy of that assessment can be challenged by renal tomography and flexible nephroscopy.

Herein is a report on 29 patients with large renal calculi treated with a combination of percutaneous nephrostolithotomy (PCNL) and ESWL. Stone-free rates were determined by KUB, renal tomography, and flexible nephroscopy. The KUB and renal tomography overestimated stone-free rates by 35% and 17% respectively, compared to flexible nephroscopy. For determining stone-free rates after ESWL, renal tomography is superior to KUB alone. Also, among patients with large renal calculi, the use of the flexible nephroscope markedly improves the stone-free rate.

Keywords

Shock Wave Lithotripsy Extracorporeal Shock Wave Lithotripsy Residual Stone Nephrostomy Tube Stone Analysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Goldwasser B, Cohan RH, Dunnick NR, et al: Role of linear tomography in evaluation of patients with nephrolithiasis. Urology 33: 253, 1989.PubMedCrossRefGoogle Scholar
  2. 2.
    Madsen EH: The value of tomography for demonstration of small intrarenal calcifications. Br J Radiol 45:2O3, 1982.CrossRefGoogle Scholar
  3. 3.
    Pfab R, Kloiber W, Kropp W, et al: The endoscopically visible radiologically non-recognizable residual fragments. Urol Res 15: 127, 1987.Google Scholar
  4. 4.
    Hulbert JC and Lange PH: The percutaneous removal of difficult upper urinary tract calculi. World J Urol 3: 19, 1985.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1989

Authors and Affiliations

  • John D. Denstedt
    • 1
  • Ralph V. Clayman
    • 2
  • Daniel P. Picus
    • 1
  1. 1.Division of Urologic SurgerySt. LouisUSA
  2. 2.Mallinckrodt Institute of RadiologyWashington University School of MedicineSt. LouisUSA

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